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OD2-PPO > Lids, lashes, and adnexa pt 2 > Flashcards

Lids, lashes, and adnexa pt 2 Flashcards

1
Q

how often does staphlococcal bleph occur on eye eyelids and conj

A

eye lids: 100%

conj: 75%

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2
Q

what is the most common pathogen involved in lid infections

A

staph aureus

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3
Q

what are the symptoms of acute staph bleph

A 
sudden onset
unilateral
associted w/ ocular surface findings 
worsening in 24-48hrs, gone in a week 
no pain, just discomfort/irritaion
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4
Q

what are the clinical ocular findings of acute staph bleph

A
  1. infl/hyperemia at lid margins
  2. collarettes at lash base
  3. conjunctival hyperemia
  4. burning or fb sensation from interaction btwn tear film and s aureus toxin
  5. vision, pupils, EOMS unaffected
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5
Q

what are the symptoms of chronic staph bleph

A
  1. present for a long period of times (months to years)
  2. bilateral
  3. assoicated w/ other lid probs
  4. history of recurrent “bumps and lumps:
  5. symptoms less severe, vague, or could be absent
  6. more common in aging population
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6
Q

what are the clinical ocular findings of chronic staph bleph

A
  1. collarettes at base of lashes
  2. thickening (tyalosis) and ulceration of lid margin bc of repeated infl, hordeola, chalazia, madarosis, poliosis,
  3. rosettes: dilated vessels at the ssurface of the lid margin
  4. dry eye of fb sensation
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7
Q

what is the manageemt of staph bleph

A
  1. warm compresses (loosen collarettes, 2x/day for 5-6 days about 10 min each time)
  2. lid scrubs (to remove collarettes, clear debris and some bact) (ocusoft&theratears or johnson and johnson diluted) 5-6 days
  3. artificial lubricants
  4. dscontinue any eye makeup products
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8
Q

in chronic cases of staph, how is the management different

A
  1. add ophthalmic meds (antibiotics, a broad spectrum to kill gram positive and gram negative)
    - bacitracin/polysporin
  2. lid hygiene aggresively, then taper off
  3. if very chronic, may need oral antibiotics (tetracycline family)
  4. artifical tears
  5. steroids reduce lid inflammation but also immuno suppress( max one week)
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9
Q

what is seborrheic blepharitis

what can cause this

A

commonly encountered
involves scalp, face, and brow area
hormones, ifection, stress, nutirion may play a role

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10
Q

what are the symptoms of seborrhic bleph

A

asymptomatic to burning
fb sensation
bilateral involvement

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11
Q

what are the clinical characteristics of seborrheic bleph

A

greasy scales, no lid infl (no hyperemia or thickening)

  • collaretes in middle of lashes
  • no lid margin ulcerations
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12
Q

what is the managaement of seborrheic bleph

A 
warm compresses
lid hygiene w/ baby shampoo 
hair/scalp treatment w/ selenuium sulfide
disontinue makeup
follow up 2-4 wks
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13
Q

when can angular blepharitis be found

A

common in the elderly
frequent in dry, warmer climates
assoicated w/ alcoholics
cause is more staph aureus and moraxella

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14
Q

what does angular bleph look like

A

maceration (skin is softened) and cracked (excoriation) /infectin of outer/inner anthus=> usually temporal side lateral area

  • usually recurrent
  • may be assciated w/ eczema
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15
Q

what is the management for angular bleph

A
  1. topical antibiotics for staph infections
  2. zinc sulphate if moraxella is cuasative agent
  3. treatment for 7-10 days
  4. discontinue cosmetics
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16
Q

what are the symptoms of angular bleph

A

irritation
itching: toxins from bateria may produce allergic rsn
canthal area redness

17
Q

what are the causes of angular bleph

A
  1. moraxella: usually younger pts and alcoholics (more prone to morazella secondary to bad diet)
  2. staph aureus: more common, eldery patients
18
Q

what are sympotoms of MGD

A
  1. dry eye symptoms
  2. non specific irritation at lid margin
  3. burning sensation bc tear film inadequate for corneal lub
19
Q

what are the clnical characteristics of MGD

A
  1. hyper secretion of meibomian glands
  2. infl of th elid margins and ocular irritation
  3. excessive secretion of lipids
  4. affecting tear production
  5. meib orficies blocked (symptoms depend on degree of capping)
20
Q

what is the difference btwn an internal/external hordloum and a chalazion

A

external hord=tender to touch/warm

21
Q

is the chance of infection greater in an external or internal hordeolum

A

internal

22
Q

what is the difference btwn a pre-septal cellulitis and orbital cellulitis

A

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

23
Q

why is an internal hordeolum larger than an external

A

bc tarsal glands are larger

24
Q

in an internal hordeolum, we use hot compresses to prevent it to developing into a….

A

chalazion

25
Q

what is the difference of development btwn a chalazion and an internal hordiolum

A

chalazion=slow onset then lesion gets bigger and bigger, focal lesion, chronic

internal hord=sudden onset, worsening over a few days afterward, acute

26
Q

what is a chalazion and how doe sit develop

A

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
27
Q

what are the complications to a chalazion

A

if recurrent in same spot could indicate sebaceous cell carcinoma
-pseudoptosis if huge

28
Q

what is the diff btwn demodex foliculorum and deodex brevis

A

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

29
Q

why is there an itchiness in demadicosis

A

waste product/reproductive cycle of mite

30
Q

who is more affected by deromex

A

eldery and people in warmer weather

31
Q

how are collarettes formed in demodex
collarettes on staph?
on seborrheic bleph?
phthiris pubic blepharitis?

A

wrapped around like a sleeve on cilia, tight
staph=at base
seborrheic= mid
phthritis=nits or eggs wrapped around cilia, ballooned out

32
Q

what is peduculosis

A

parasitic infection
2 types: pediculus umanus-head louse and body luse
phthiris pubis-crab louse

33
Q

what is verruca caused by

A

HPV

  • viral
  • grouping, no space, multiple lobed lesion
34
Q

what is molluscum contagiosum caused by

A

aids population

DNA pox virus: epidermal infection

35
Q

what causes contact dermatitis

A

allergic rxn from exogenous source (makeup)

common

OD2-PPO (8 decks)

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