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Clin Med - Ophthalmology > Lids, Lashes, & Orbital Disease > Flashcards

Lids, Lashes, & Orbital Disease Flashcards

1
Q

Blepharitis (define)

A
  • eyelid inflammation

- acute or chronic

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2
Q

Blepharitis (etiology)

A
  • staph
  • seborrheic
  • meibomian gland dysfunction
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3
Q

Blepharitis (signs)

A
  • erythematous, edematous, greasy, crusty lids
  • collarettes
  • lash loss
  • thick, cloudy secretions with digital pressure on meibomian orifaces
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4
Q

Blepharitis (symptoms)

A
  • irritation/burning
  • FB sensation
  • excessive tearing
  • photophobia
  • intermittent blurry vision
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5
Q

What are collarettes?

A
  • fibrinous scales around lashes
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6
Q

Blepharitis (tx)

A
  • warm compress
  • improved eyelid hygiene
  • topical abx ointment
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7
Q

T/F: Blepharitis is a one time disorder.

A

False; frequently recurs

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8
Q

What is another name for a stye?

A
  • Hordeolum
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9
Q

stye (symptoms)

A
  • subacute onset

- painful nodule or pustule of eyelid

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10
Q

stye (signs)

A
  • tender, erythematous, nodule on skin surface of eyelid
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11
Q

stye (etiology)

A
  • staph infection of a sebaceous gland of the lid
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12
Q

stye (tx)

A
  • warm compress
  • topical abx drops
  • I&D if abx fail
  • prevent cellulitis
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13
Q

How are styes and blepharitis ddx’d?

A
  • no discharge with styes
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14
Q

chalazion (symptoms)

A
  • asymptomatic
    or
  • minimally tender lid nodule
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15
Q

chalazion (signs)

A
  • firm, well-demarcated nodule inferior to lid margin

- grayish conjunctiva

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16
Q

chalazion (etiology)

A
  • chronic inflammation of the meibomian gland
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17
Q

chalazion (tx - early)

A
  • early: warm compress
  • intermediate: steroid injx (synthetic - trimcinolone)
  • late: surgery
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18
Q

How are chalazion and styes ddx’d?

A
  • chalazion is not tender
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19
Q

eyelid HSV (tx - mild cases)

A
  • good hygiene to decrease risk of 2ndary bacterial infection
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20
Q

eyelid HSV (tx - moderate to severe cases)

A
  • topical polysporin to keep bacterial count down

- trifluridine drops to prevent 2ndary herpetic keratitis

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21
Q

What is dacryocystitis?

A
  • lacrimal sac infection
22
Q

What is dacroadenitis?

A
  • lacrimal gland infection
23
Q

Define entropion

A
  • inversion of the eyelid
24
Q

Define ectropion

A
  • sagging or eversion of the lid
25
Q

ectropion (symptoms)

A
  • irritation
  • burning
  • tearing
  • RB sensation
26
Q

ectropion (signs)

A
  • lower lid turned outward

- visible space seen between globe and lid

27
Q

ectropion (etiology)

A
  • involutional = lower lid laxity 2ndary to aging
  • paralytic = caused by CN VII palsy
  • scarring of lower lid
  • mass on lower lid or cheek
28
Q

entropion (symptoms)

A
  • irritation
  • burning
  • FB sensation
29
Q

entropion (signs)

A
  • inturned lower lid
30
Q

entropion (etiology)

A
  • involutional = lower lid laxity caused to aging

- scarring from chemical burn

31
Q

What is ptosis?

A
  • drooping of the upper eyelid
  • caused by CN III palsy
  • aka Horner’s syndrome
32
Q

xanthelasma (symptoms)

A
  • yellowish deposit around lids

- otherwise asymptomatic

33
Q

xanthelasma (signs)

A
  • bilateral plaque/yellow lesion in medial and upper eyelid
34
Q

Define blepharospasm

A
  • twitching eyelid
35
Q

What innervates the superior rectus?

A
  • CN III
36
Q

What innervates the inferior rectus?

A
  • CN III
37
Q

What innervates the medial rectus?

A
  • CN III
38
Q

What innervates the lateral rectus?

A
  • CN VI
39
Q

What innervates superior oblique?

A
  • CN IV
40
Q

What innervates inferior oblique?

A
  • CN III
41
Q

Describe orbital cellulitis

A
  • inflammation or infection of the orbit spreading from the sinuses
42
Q

orbital cellulitis (symptoms)

A
  • cardinal signs of swelling (warm, red, tender, swollen)

- vision loss & diplopia 2ndary to non-tandem movements of the eye

43
Q

orbital cellulitis (signs)

A
  • low grade fever
  • elevated WBC
  • proptosis
  • restricted motility of the eye
44
Q

orbital cellulitis (etiology)

A
  • URI or sinusitis –> streph, staph, or mixed flora
  • lid trauma
  • preseptal cellulitis
  • superficial lid or conjunctival infections
  • surgical procedures with contamination
45
Q

orbital cellulitis (ddx)

A
  • orbital preseptal cellulitis
  • orbital pseudotumor
  • carotid cavernous fistula
46
Q

orbital cellulitis (workup)

A
  • CBC
  • culture if open wound
  • CT
  • blood culture if systemic source suspected
47
Q

orbital cellulitis (tx)

A
  • IV broad spec abx
  • surgical drainage
  • sinus drainage
  • refer
48
Q

How are thyroid eye disease and orbital cellulitis ddx’d?

A
  • thyroid eye is bilateral
49
Q

thyroid eye disease (symptoms)

A
  • gradual onset
  • mild: irritation, tearing, burning, FB sensation
  • moderate: diplopia, achiness, blurred vision
  • severe: visual loss, pain
50
Q

thyroid eye disease (signs)

A
  • proptosis/exophthalmos
  • lid lag
  • sclera seen above or below iris
  • restricted EOM
  • conjunctival dilated blood vessels
  • lid, conjunctival edema
  • decreased visual acuity
  • possible visual field loss
51
Q

thyroid eye disease (etiology)

A
  • thyroid abnormalities (i.e. hyperthyroidism - Graves)

- autoimmune (i.e. Hashimoto’s)

52
Q

thyroid eye disease (workup)

A
  • thyroid testing including TSH levels
  • CT/MRI
  • refer

Clin Med - Ophthalmology (13 decks)

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