Lid lumps (eyelid disorders) and periocular tumours Flashcards

1
Q

define blepharitis

A

inflammation of the eyelid margins

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2
Q

presentation of blepharitis 3

A

gritty, itchy, dry sensation in the eyes

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3
Q

what can blepharitis be caused by

A

dysfunction of the meibomian glands

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4
Q

what is the function of the meibomian glands

A

secrete oil unto the surface of the eye

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5
Q

what can blepharitis lead to 2

A

styes
and
chalazions

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6
Q

management of blepharitis

A

hot compressess and gentle celeaning of the eyelid margins to remove debris using cotton wool dipped in sterilised water and baby shampoo

lubricating eye drops can be used to relive syx
-hypromellose
-polyvinyl alcohol
-carbomer

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7
Q

types of stye 2

A

hordeolum externum

hordeolum internum

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8
Q

what is a hordeolum externum stye caused by 2

A

infection of either the glands of Zeis or glands of Moll

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9
Q

what is a hordeolum internum stye caused by

A

infection of the meiobiam glands

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10
Q

define the glands of moll

A

sweat glands at the base of the eyelashes

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11
Q

define the glands of zeis

A

sebaceous glands at the base of the eyelashes

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12
Q

presentation of styes 2

A

a tender red lump along the eyelid that may contain pus

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13
Q

how does a horrdeolum internum stye present differently to a hordeolum externum stye 3

A

usually deeper
-tend to be more painful
-may point inwards towards the eyeball underneath the eyelid

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14
Q

treatment for styes 2

A

hot compressess and analgesia

consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent

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15
Q

define a chalazion

A

when the meibomian gland becomes blocked and swells up
-often called a meibomian cyst

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16
Q

how does a chalazion presnet 2

A

swelling in the eyelid that is typically not tender

it can be tender and red tho

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17
Q

treatment of chalazion 3

A

hot compress and analgesia

consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent

if conservative mangemtn fails (rarely)- consider surgical drainage

18
Q

type entropion

A

where the eyelid turns inwards with the lashes against the eye ball

19
Q

presentation of entropion 2

A

pain

can result in corneal damage
or
corneal ulceration

20
Q

management of entropion 2

A

inital Mx- tape eyelid down to prevent it turning inwards
-whilst taped down use regular lubricating eye drops to prevent eye drying out

diffinitve mangemnt- surgical intervention

if risk to sight-same day referral to ophthal

21
Q

define ectropion

A

where eyelid turns outwards with inner aspect of eyelid exposed
-usually affects bottom lid

22
Q

what can ectropion cause

A

exposure keratopathy
-as eyeball is ecposed and not aequalty lubiracted and protected

23
Q

define exposure keratopathy

A

damage to the cornea that occurs primarily from prolonged exposure of the ocular surface to the outside environment. EK can lead to ulceration, microbial keratitis, and permanent vision loss from scarring.

24
Q

managemtn of ectropion 3

A

mild cases- no treatment

-regular lubricating eye drops are used to protect the surface of the eye

-more significant cases may require surgery to correct the defect

if risk to sight- same day referral

25
Q

define trichiasis

A

inward growth of eyelashes

26
Q

presentaion of trichiasis 3

A

pain
-can result in corneal damage and ulceration

27
Q

managemtn of trichiasis 2

A

specalist remove eyelash- epilation

recurrent cases may need electrolysis,cryoterpay or laser treatment to prevent lash regrowing

risk to sight-same day referral

28
Q

define periorbital cellulits

A

also known as preorbital cellulits

-eyelid and skin infection in front of orbital septum (in front of the eye)

29
Q

how does periorbital cellulits present 3

A

swelling

redness

hotskin

(above found around the eyelids and eye)

30
Q

what is an improatnt differntial for periorbital cellulitis and how is this confirmed

A

important differnrtial is orbital cellulits
-this is sight and life threatening emergency

To distinguish
-use CT scan

31
Q

management of periorbital cellulits 1

A

systemic ABx

*-can develop into orbital cellulits so kids and vulnerable groups or severe cases may need admission to observe

32
Q

define orbital cellulits

A

infection around the eyeball that involves tissues BEHIND THE ORBITAL SEPTUM

33
Q

what key features differntiate orbital cellulitis from periorbital 5

A

pain on eye movement

reduced eye movmemtns

changes in vision

abnormal pupil reactions

proptosis (forward movement of eyeball)

34
Q

what key features differntiate orbital cellulitis from periorbital 5

A

pain on eye movement

reduced eye movmemtns

changes in vision

abnormal pupil reactions

proptosis (forward movement of eyeball)

35
Q

management of orbital cellulits 2

A

medical emergency
required admission and IV ABx

may need surgical drainage if abscess forms

36
Q

risk factors for orbital cellulits 5

A

childhood

previous sinus infection

no Haemophils influzae B vaccination

recent eyelid infecton/ insect bite on eyelide

ear or facial infection

37
Q

what usually causes orbital cellulits

A

spreading URTI from the sinuses

38
Q

IX for orbital cellullits

A

FBC

full opthal exam

*-CT WITH CONTRAST - inflammation of the orbital tissues deep to the septum, sinusitis

39
Q

define periocular skin caner

A

involes the skin of the eyelid or around the eye

-usually occur on the lowereyelid

40
Q

most common types of periocular skin cancer

A

usually basal cell carincoma

less common SCC, sebaceous gland carcinoma and malignant melanoma

41
Q

most common ocular tumour

A

choroidal melanoma

42
Q

treatment for periorcular skin tumours 2

A

prinicples
-complete removal

-reconstrution of eyelid