Lids, lashes, and adnexa pt 2 Flashcards
how often does staphlococcal bleph occur on eye eyelids and conj
eye lids: 100%
conj: 75%
what is the most common pathogen involved in lid infections
staph aureus
what are the symptoms of acute staph bleph
sudden onset unilateral associted w/ ocular surface findings worsening in 24-48hrs, gone in a week no pain, just discomfort/irritaion
what are the clinical ocular findings of acute staph bleph
- infl/hyperemia at lid margins
- collarettes at lash base
- conjunctival hyperemia
- burning or fb sensation from interaction btwn tear film and s aureus toxin
- vision, pupils, EOMS unaffected
what are the symptoms of chronic staph bleph
- present for a long period of times (months to years)
- bilateral
- assoicated w/ other lid probs
- history of recurrent “bumps and lumps:
- symptoms less severe, vague, or could be absent
- more common in aging population
what are the clinical ocular findings of chronic staph bleph
- collarettes at base of lashes
- thickening (tyalosis) and ulceration of lid margin bc of repeated infl, hordeola, chalazia, madarosis, poliosis,
- rosettes: dilated vessels at the ssurface of the lid margin
- dry eye of fb sensation
what is the manageemt of staph bleph
- warm compresses (loosen collarettes, 2x/day for 5-6 days about 10 min each time)
- lid scrubs (to remove collarettes, clear debris and some bact) (ocusoft&theratears or johnson and johnson diluted) 5-6 days
- artificial lubricants
- dscontinue any eye makeup products
in chronic cases of staph, how is the management different
- add ophthalmic meds (antibiotics, a broad spectrum to kill gram positive and gram negative)
- bacitracin/polysporin - lid hygiene aggresively, then taper off
- if very chronic, may need oral antibiotics (tetracycline family)
- artifical tears
- steroids reduce lid inflammation but also immuno suppress( max one week)
what is seborrheic blepharitis
what can cause this
commonly encountered
involves scalp, face, and brow area
hormones, ifection, stress, nutirion may play a role
what are the symptoms of seborrhic bleph
asymptomatic to burning
fb sensation
bilateral involvement
what are the clinical characteristics of seborrheic bleph
greasy scales, no lid infl (no hyperemia or thickening)
- collaretes in middle of lashes
- no lid margin ulcerations
what is the managaement of seborrheic bleph
warm compresses lid hygiene w/ baby shampoo hair/scalp treatment w/ selenuium sulfide disontinue makeup follow up 2-4 wks
when can angular blepharitis be found
common in the elderly
frequent in dry, warmer climates
assoicated w/ alcoholics
cause is more staph aureus and moraxella
what does angular bleph look like
maceration (skin is softened) and cracked (excoriation) /infectin of outer/inner anthus=> usually temporal side lateral area
- usually recurrent
- may be assciated w/ eczema
what is the management for angular bleph
- topical antibiotics for staph infections
- zinc sulphate if moraxella is cuasative agent
- treatment for 7-10 days
- discontinue cosmetics
what are the symptoms of angular bleph
irritation
itching: toxins from bateria may produce allergic rsn
canthal area redness
what are the causes of angular bleph
- moraxella: usually younger pts and alcoholics (more prone to morazella secondary to bad diet)
- staph aureus: more common, eldery patients
what are sympotoms of MGD
- dry eye symptoms
- non specific irritation at lid margin
- burning sensation bc tear film inadequate for corneal lub
what are the clnical characteristics of MGD
- hyper secretion of meibomian glands
- infl of th elid margins and ocular irritation
- excessive secretion of lipids
- affecting tear production
- meib orficies blocked (symptoms depend on degree of capping)
what is the difference btwn an internal/external hordloum and a chalazion
external hord=tender to touch/warm
is the chance of infection greater in an external or internal hordeolum
internal
what is the difference btwn a pre-septal cellulitis and orbital cellulitis
presept: infection spread from its focal area to involve upper and lower adnexa, infection of orbital septum, localized but diffuse, focal area of hordeloum spreading. VA, pupils, EOMs normal
orbital: ocular emergency, entire adnexa involved, lotsa edema, infection beyond the orbital septum,
- VA compromised, EOMs restricted, pupils affected
- pain, redness, edema, fever
why is an internal hordeolum larger than an external
bc tarsal glands are larger
in an internal hordeolum, we use hot compresses to prevent it to developing into a….
chalazion
what is the difference of development btwn a chalazion and an internal hordiolum
chalazion=slow onset then lesion gets bigger and bigger, focal lesion, chronic
internal hord=sudden onset, worsening over a few days afterward, acute
what is a chalazion and how doe sit develop
lipo-granulomatosis infl of meib glands, cuased by retention of granulation tissue
- can get after interal hord or independent of
- sterile swelling, not infection
- recurrent
what are the complications to a chalazion
if recurrent in same spot could indicate sebaceous cell carcinoma
-pseudoptosis if huge
what is the diff btwn demodex foliculorum and deodex brevis
folliculorum: hair follicle, larger, abdomen round, eggs are arrow shaped 0,1mm diamter
brevis: sebaceous gland, smaller, abdomen pointed, eggs are oval shaped and 0.06 diamter
why is there an itchiness in demadicosis
waste product/reproductive cycle of mite
who is more affected by deromex
eldery and people in warmer weather
how are collarettes formed in demodex
collarettes on staph?
on seborrheic bleph?
phthiris pubic blepharitis?
wrapped around like a sleeve on cilia, tight
staph=at base
seborrheic= mid
phthritis=nits or eggs wrapped around cilia, ballooned out
what is peduculosis
parasitic infection
2 types: pediculus umanus-head louse and body luse
phthiris pubis-crab louse
what is verruca caused by
HPV
- viral
- grouping, no space, multiple lobed lesion
what is molluscum contagiosum caused by
aids population
DNA pox virus: epidermal infection
what causes contact dermatitis
allergic rxn from exogenous source (makeup)
common
