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Abnormal Ocular Conditions > Lids > Flashcards

Lids Flashcards

1
Q

What is a squamous papilloma?

A

A benign skin tag - flesh coloured growth made of squamous hyperplasia within the epithelium

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2
Q

How can a squamous papilloma be treated?

A

Excision for cosmesis or effect on vision

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3
Q

What is seborrheic keratosis?

A

Elevated, pigmented, greasy, stuck on plaque
Benign but sudden increase in number or size could indicate systemic malignancy
Develop from intradermal proliferation of basal cells within epidermis
Benign

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4
Q

How can seborrheic keratosis be treated?

A

Complete excision

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5
Q

What are epidermal inclusion cysts?

A

Slowly englarging keratin filled cysts
Benign

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6
Q

How can epidermal inclusion cysts be treated?

A

Excision and curettage

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7
Q

What is verruca vulgaris?

A

AKA viral wart
Epidermal growth caused by HPV
Filiform: project from the skin
Plana: flat
Benign

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8
Q

What can verruca vulgaris cause on the eye?

A

Punctate keratitis
Corneal pannus

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9
Q

How can verruca vulgaris be treated?

A

Often outgrow blood supply and involute (return to original size)
Excision
Cryotherapy
Chemical cautery
Only cosmetic or if eye irritation

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10
Q

What is molluscum contagiosum?

A

1-2mm flesh-coloured papules (often umbilicated centre)
More common in very young and immunocompromised pxs
Spread by skin to skin contact - low transmission rate
Benign

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11
Q

How can molluscum contagiosum be treated?

A

Normally regress spontaneously
If immunocompromised, can develop into disfiguring lesions

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12
Q

What is pyogenic granuloma?

A

Pinkish red, vascularised mass protruding from conjunctiva
Rapid growth, usually a local trauma response
Made of blood vessels and fibroblasts - bleed very easily
Benign

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13
Q

What is ephelides?

A

AKA freckles
1-3mm tan or brown macules in sun exposed areas of skin
Occur more in lighter skin, worsen with sun exposure
No treatment but adv sun protection to minimise appearance
Benign

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14
Q

What are sebaceous/pilar cysts?

A

Blocked pilosebaceous follicles containing sebum
May arise from glands of Zeis, meibomian glands or sebaceous glands assoc with hair follicles
Benign

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15
Q

What is actinic keratosis (AK)?

A

AKA solar keratosis
Pink or red scaly lesion on sun-exposed areas of skin
Pre-malignant - 25% develop into squamous cell carcinoma

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16
Q

What is keratoacanthomas?

A

Rapidly growing papules with keratin filled core
Usually elderly or immunocompromised pxs
Can resolve over a few months but excision recommended due to 12% risk of conversion to squamous cell carcinoma

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17
Q

What causes eyelid myokymia (twitching eyelids)?

A

Stress, fatigue, eyestrain, excessive caffeine consumption

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18
Q

How do you confirm a diagnosis of eyelid myokymia?

A

Episodic
Localised to eyelid
Painless
No functional impairment

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19
Q

How do you treat eyelid myokymia?

A

Rest
Cold compress
Tonic water
Stress reduction
Botox if excessive

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20
Q

When should you investigate eyelid myokymia?

A

Persistent cases

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21
Q

What are the signs of blepharitis?

A

Crusting
Greasy deposits
Lid hyperaemia
More prone to styes
Secondary: lash misdirection, madarosis, poliosis, superficial epithelial punctate staining, marginal keratitis, neovasc

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22
Q

What are the symptoms of blepharitis?

A

Irritation
Itching
Burning
Soreness
Dry eye sx
Mild photophobia

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23
Q

What is aetiology of blepharitis?

A

Bacterial (allergic or infection)
Demodex infestation
Sebborrheoic (gland of Zeis disorder)

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24
Q

What are some predisposing factors for blepharitis?

A

Dandruff
Oily skin
Ocular rosacea
Allergies affecting lids

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25
What is the management of blepharitis?
Chronic so needs consistent treatment: Lid hygiene 2x daily Warm compress and massage Ocular lubricants Steroids if severe or tx not working
26
What are the signs of MGD?
Thick secretion Difficult to secrete oil Foamy tears Unstable tear film Lid/conj hyperaemia Secondary: superficial epithelial punctate staining, marginal keratitis, neovasc
27
What are the symptoms of MGD?
Irritation Itching Burning Soreness Mild photophobia Dry eye sxs
28
What is the aetiology of MGD?
Bacteria break down lipids, leading to blocked glands and unstable tear film
29
What are some predisposing factors for MGD?
Hormone imbalances Sjrogen's syndrome Steven-Johnson syndrome Psoriasis Rosacea Some meds e.g. antidepressants
30
What is the management for MGD?
Lid hygiene Warm compress and massage Lubricants
31
What are the signs of ectropian?
Visible punctum Conj hyperaemia Epiphora Keratopathy (e.g. smile stain) Incomplete blink
32
What are the sxs of ectropian?
Watery Red Sore
33
What is the snap back test?
Checks for lid laxity - can the lid be pulled >8mm from the globe?
34
What are the possible aetiologies of ectropian?
Age related weakening of muscles Scarring (traum/burns/surgery/chronic bleph) Paralytic (CN7 palsy) Mechanical (tumour) Congenital
35
How should ectropian be managed?
Treat sxs (lubricants) Poss surgery referral Avoid lid rubbing Lid taping at night Bandage CLs
36
What are the signs of entropian?
Corneal/conj staining Conj redness Conj scarring if left untreated Corneal ulcer (rare)
37
What are the sxs of entropian?
FB sensation Irritation Red eye Watery Blurred vision
38
How can you check for intermittent entropian?
TIE 2 test: hold upper lid and ask px to look down - entropian will be induced if present
39
What are the possible aetiologies of entropian?
Age related Scarring Spastic Congenital
40
What are the RFs for entropian?
Age Previous surgery Previous chemical injury Trachoma Steven-Johnson syndrome
41
How should entropian be managed?
Sx treatment Can epilate lashes Poss surgery referral
42
What is Bell's palsy?
7th Nerve palsy Unilateral
43
What is the mnemonic for Bell's Palsy?
B:link reflex abnormal E:arache L:acrimation (reduced or excess) L:oss of taste S:udden onset P:alsy of VII nerve muscle (hearing loss, vertigo, nystagmus, tinnitus)
44
What are the signs of Bell's palsy?
Unilateral sagging of face (eyelid, eyebrow, mouth) Exposure keratopathy due to incomplete blink
45
What are the symptoms of Bell's palsy?
Sudden onset Unilateral facial weakness Earache/hearing loss Dry mouth Difficulty chewing Taste changes Numbness/tingling Difficulty speaking/drooling Incomplete blink Dry eye/pain Excessive or lack of tearing
46
What are the possible aetiologies of Bell's palsy?
Idiopathic Autoimmune Injury Circulation problems Blood disorders Tumours Neuro
47
What are the RFs for Bell's palsy?
Viral infection (e.g. rubella, mumps, flu) Trauma Tooth extraction Diabetes 3rd trimester pregnancy
48
What is the management for Bell's palsy?
Treat sxs (lubricant, lid tape, bandage CLs) Refer to GP
49
What symptoms may a patient with ptosis experience?
Brow ache Eyestrain Fatigue Cosmetic concerns
50
What are the possible aetiologies for ptosis?
Age Congenital 3rd nerve palsy RAPD Myasthenia gravis Myotonic dystrophy Injury Mechanical
51
What are the RFs for ptosis?
Age Eye tumour Diabetes Stroke Cancer Neurological disorder
52
What is the management for ptosis?
Lid taping (may cause dryness) Refer routinely for surgery if appropriate
53
What is a chalazion?
Inflammation due to MG blockage Well defined bump 2-8mm May see conj granuloma on lid eversion
54
What are the symptoms of a chalazion?
No pain Blurred vision Cosmetic concerns
55
What are the RFs for chalazion?
Viral conjunctivitis Eye/lid infection Seborrhoeic dermatitis Ocular rosacea
56
How should a chalazion be managed?
Warm compress and massage If unresolved after 2-6 months: routine referral
57
What are the signs of a hordeolum?
Tender inflamed swelling either internal or external
58
What are the symptoms of a hordeolum?
Tender lump Epiphora Discharge Lid hyperaemia
59
What is the aetiology of hordeolum?
Bacterial infection MG blockage Gland of Zeis/Moll blockage
60
What are the RFs for hordeolum?
CL wear Poor hygiene Not removing make up Blepharitis Rosacea/dermatitis Diabetes
61
How should hordeolum be managed?
Warm compress and massage Chloramphenicol
62
What is the management for papilloma, cyst of Moll and cyst of Zeis?
None Can refer for removal if bothering px
63
What colour is a cyst of moll?
Translucent
64
What colour is a cyst of zeis?
Opaque
65
What are the signs of basal cell carcinoma?
50-60% on lower lid Nodular Discharge Crusting Lashes affected Loss of skin texture Becomes pigmented later
66
What are the sxs of basal cell carcinoma?
Gradual onset May bleed No pain
67
What are the possible aetiologies for basal cell carcinoma?
UV exposure FH Immunocompromised Caucasians Age Female
68
What should you do when monitoring external eye lesions?
Photograph and document well
69
What is the management for basal cell carcinoma?
Take a photo Sunglasses Routine/urgent referral
70
What are the signs of squamous cell carcinoma?
On lower lid Raw Scaly Bloodshot Keratosis
71
What are the sxs of squamous cell carcinoma?
Quicker onset than basal cell carcinoma Sore
72
What are the possible aetiologies for squamous cell carcinoma?
UV Scars Age Male Actinic keratosis
73
What are the RFs for squamous cell carcinoma?
UV Immunocompromised Skin cancer history >50 Caucasian Male HPV history Chronic skin infection from burns
74
How should squamous cell carcinoma be managed?
Urgent referral for surgery
75
What are the signs for sebaceous carcinoma?
Upper lid Firm, enlarging nodule causing lash loss or misdirection Spread to conjunctiva
76
What are the sxs for sebaceous carcinoma?
Gradual onset blurred vision
77
What are the RFs for sebaceous carcinoma?
40-60 years old Female Immunosuppression (may present younger) Asian
78
How should sebaceous carcinoma be managed?
Take a photo Refer urgently for radiation/surgery
79
What are the signs of a malignant melanoma?
Changing naevus: colour, bleeding, elevated borders, variable pigment Lash loss Notching
80
What are the sxs of a malignant melanoma?
Painless Bleeding Ulcer
81
What are the ABCDEs of melanoma?
Asymmetry: two halves not symmetric Borders: irregular, or satellite pigmentation Colour: uneven colour/changes Diameter: enlarging size or >6mm Elevation: not relevant to lid lesions (most are elevated)
82
What is the aetiology of malignant melanoma?
UV exposure
83
What are the RFs for malignant melanoma?
Age UV exposure Naevus FH Immunosuppression Crohn's disease
84
How should malignant melanoma be managed?
Urgent referral

Abnormal Ocular Conditions (9 decks)

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