Lid Margin Diseases Flashcards
1
Q
Staph Blepharitis
A
- less common form, curable with antibiotics
- presents with hard crust, collarettes (from demodex?), follicles
2
Q
Seborrheic Blepharitis
A
- strongly associated with derma disorders like seborrhea and rosacea
- greasy crusts, papillofollicular response
- chronic low grade symptoms
3
Q
Mixed Blepharitis
A
-more common than staph alone
4
Q
Meibomian Keratoconjuntivitis
A
- bleph involving the cornea
- may see ulcers forming at 10, 2, 4, 8 o’clock
- staph toxins and free fatty acids can cause the keratitis
5
Q
Meibomian Seborrhea or Meibomian Gland Dysfunction
A
- Tx: may require oral antibiotics+expression
- typically treat with doxycycline, or erythromycin if doxycycline contraindicated
6
Q
Demodex
A
- mite that inhabits lashes
- previously thought to increase inflammation with proliferation
- now thought that it deposits staph onto lashes, leaving to formation of collarette (demodex serves as a VECTOR)
7
Q
Keractoconjunctivitis sicca
dry eye syndrome
A
K. Sicca or dry eye occurs along with lid disease in many patients
-most commonly associated with Staph bleph (50%), but also with seborrheic, MKC, and MG
8
Q
Acne Rosacea
A
- skin condition, teleangectasia of facial blood vessels, rapid turnover of epithelial cells, pustules form on cheeks
- progresses to RHINOPHYMA (pores of nose swell, vessels dilate and enlarge nose, nose has irregular surface characteristic of acne rosacea)
- mimics ocular pemphigoid
- acne rosacea patients susceptible to staph infections, and this disease strongly associated with lid margin disorders (78% MGD, 65% bleph)
- Dx: SIBO tests small intestine for bacterial growth, then treated with rifaximin
9
Q
Ocular Rosacea
A
- can occur with no other facial signs/symptoms
- patient will have bleph, inflammation, tearing, chalazia/hordeolum, corneal vascularization, scarring of cornea or conj, thinning of cornea, perforation
- application of Metrogel to lids can help
10
Q
Seborrhea
A
- sebaceous gland dysfunction where there is an over production of sebum and rapid cell turnover
- can be diffuse or localized; may be related to atopic disease (hypersensitivity rxn)
- patient will have dermatitis (inflammation of skin), dandruff, flaky scaly skin/scalp, prone to eczema
- 36% patients will develop primary MKC, where to treat the MKC must treat the underlying seborrhea with dermatologist
11
Q
Angular Blepharitis
A
- Moxaxella or Staph atopy
- red flaky, ulcerative canthus (lateral > medial), irritation and tenderness
- Tx: Zn sulfate, bacitracin
12
Q
Hordeolum
A
- infectious by nature
- red, painful, tender nodule
- external: drained by removal of lash, lance the peak, may require complete excision
- internal: involves the meibomian glands; may require excision and may peak externally
- hordeolums leave scars after resolution
13
Q
Chalazion
A
- caused by granulomatous inflammation; may occur secondary to hordeolum after the infection has subsided
- if large enough, may induce corneal astigmatism
- excision can be done for cosmesis or if interrupting vision; steroid injections less common
14
Q
Concretion
A
-calcified sebaceous material
15
Q
Distichiasis
A
- an extra row of lashes that grow from meibomian gland openings
- can cause ingrown eye lash, corneal foreign body sensation, tracking
