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Part 1 > Lids/Lashes/Lacrimal System > Flashcards

Lids/Lashes/Lacrimal System Flashcards

1
Q

What are the general lids/lashes/lacrimal system disease?

A
  1. Dermatochalasis
  2. Blepharochalasis
  3. Blepharitis
  4. Hordeolum –> Chalazion
  5. Ectropion
  6. Entropion
  7. Floppy Eyelid Syndrome
  8. Benign Essential Blepharospasm
  9. Meige syndrome
  10. Myokia
  11. Keratoacanthoma
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2
Q

What is a rare lid disease that affects young pts and causes repeated episodes of acute eyelid swelling?

A

Blepharochalasis

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3
Q

What are the signs of Staph Blepharitis?

A
  1. Collarettes
  2. Impale cilia
  3. Crusts
  4. Fibrinous impaled cornflakes

NOTE: Staph epidermidis > S. aureus

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4
Q

What are the signs of Seborrheic Blepharitis?

A
  1. Oily greasy scales
  2. Sleeves
  3. Madarosis
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5
Q

What is an acute infection (staph) of MGs called?

A

Internal hordeolum

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6
Q

What is an acute infection of the Zeiss/Moll?

A

External Hordeolum

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7
Q

Benign essential blepharospasm is spasms of which muscles?

A
  1. Orbicularis oculi
  2. Procerus
  3. Corrugator musculature

NOTE: may cause TMJ. Tx: Botox*

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8
Q

What is Meige’s syndrome characterized by?

A

BEB & lower facial abnormalities (i.e. difficulty chewing & opening the mouth, jaw spams, jaw pain, etc)

~50% pts w BEB have Meige’s syndrome

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9
Q

Describe Keratoacanthoma.

A
  1. Middle aged
  2. Males
  3. UV exposure
  4. Fast growth (~8 weeks)
  5. Shrinks & resolves on own
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10
Q

What are examples of eyelid cysts?

A
  1. Epidermal inclusion cyst (EIC)
  2. Milia
  3. Sebaceous cyst
  4. Sudoriferous cysts

NOTE: these are typically benign lesions that develop from the epithelium, often associated w the meibomian, sebaceous, and sweat glands of the eyelids

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11
Q

What is an acquired lesion found on the lid and surrounding adnexal tissue that may appear WHITE & is due to occlusion of sweat pores OR pilosebaceous follicles?

A

Milia

“small buried grains of white rice”

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12
Q

What is characterized by retention of fluid in the glands of Zeiss or retention of debris in the Meibomian glands?

A

Sebaceous Gland Cysts

Solitary, smooth lesions that are YELLOW or OPAQUE

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13
Q

Which eyelid cysts are elevated round lesions caused by blockage of the gland of MOLL?

A

Sudoriferous cysts

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14
Q

What are examples of infections of the lids/lashes?

A
  1. Pthiriasis palpebrum

2. Demodicosis

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15
Q

Hx of crab louse

Can be seen on eyelashes uni or bilaterally + blood-tinged debris

What do you think?

A

Phthiriasis palpebrum

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16
Q

Demodex on lashes

Eye pain in the morning*

See sleeving of the base of the lashes.

What do you think?

A

Demodicosis

Lice live in the follicles, come out to hatch eggs at night

17
Q

What are the malignant growths of the lids/lashes?

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Sebaceous gland carcinoma
  4. Malignant melanoma
18
Q

Which malignant growth of the lid is the most common skin cancer in the US?

A

BCC

NOTE: also most common eyelid cancer

19
Q

Profile of BCC?

A
  1. Males
  2. Fair skin
  3. UV
  4. Malignancy of basal cells=shiny pearly nodule w surface TELANGIECTASIA –> rodent ulcer
20
Q

What is the 2nd most common eyelid malignancy?

A

Squamous cell carcinoma

NOTE: malignancy of the spinosum layer of epidermis AND MORE AGGRESSIVE than BCC

21
Q

Name the progression toward Squamous Cell Carcinoma.

A

ACTINIC KERATOSIS (pre-cancer) –> CIN (carcinoma in situ) –> SCC (malignany) = erythematous plaque, rough/scaly

(-) surface telangiectasia

22
Q

Which malignant growth of the lids is rare, seen in ELDERLY females, Hx of chalazia, highly infiltrative + inflammatory, with a HIGH MORTALITY rate?

A

Sebaceous Gland Carcinoma

NOTE: malignancy of sebaceous glands (Meibomian/Zeis). Can mimic BCC

23
Q

Which malignancy of the lids is the MOST lethal Primary Skin Cancer?

A

Malignant melanoma

NOTE: malignancy of the melanocytes

24
Q

Prognosis of Malignant melanoma depends on?

A

DEPTH of invasion

25
Q

Progression of Malignant Melanoma?

A

LENTIGO maligna (pre-cancer) + Primary Aquired Melanosis (PAM) –> MM

26
Q
  • Children/young adults
  • Hx bacterial/viral infection (vs sarcoid/grave’s vs idiopathic orbital inflamm)
  • Swelling of outer 1/3 temporal upper lid
  • Acute S shaped ptosis (chronic > acute episodes)
  • (+) PAL
  • Redness
A

Dacryoadenitis

27
Q

Relevant Lacrimal System Disorders?

A
  1. Dacryoadenitis
  2. Dacryocystitis
  3. Canaliculitis
  4. Nasolacrimal duct obstruction
  5. Punctal Stenosis
28
Q
  • Ear/nose/throat infection
  • Lacrimal drainage obstructed
  • ACUTE PAIN&raquo_space;
  • Kids
A

Dacryocystitis

29
Q

Chronic cases of Dacryocystitis should raise suspicion for what?

A

Epithelial carcinomas and malignant lymphomas

NOTE: carcinomas can express blood in the tear film w palpation of the lacrimal sac

30
Q
  • Viral/fungal
  • Actinomyces israelii (canals + yellow rocks)
  • Swollen pounting puncta
  • Unresponsive to Ab Tx, mis-Dx as conjunctivitis
A

Canaliculitis!

31
Q
  • Congenital (membranous block of valve of Hasner)
  • Acquired (involutional)
  • Unilateral epiphora
  • Reopens 1-2 months after birth
  • Can cause secondary dacryocystitis
A

Nasolacrimal Duct Obstruction

NOTE: 5-30% new borns

32
Q
  • Narrowing or occlusion of puncta of upper and/or lower lid
  • Older age
  • Epiphora
A

Punctal Stenosis

33
Q

Which Jones I or II is a Patent System?

A

Jones 1

Meaning if you blow nose into tissue –> NaFl will follow

If don’t see NaFl –> (-) –> Obstruction –> Move on to Jones II

34
Q

What does Reflex Fluid mean in Jones 2?

A

Upper/lower canaliculus blockage (proximal to common canaliculus)

35
Q

What does retrograde flow through opposite canaliculus mean?

A

Nasolacrimal blockage

36
Q

What does it mean if they taste saline/recover in nose during Jones 2?

A

Cleared

Part 1 (31 decks)

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