MDT eye Hordeolum and Chalazion

Question 1

What are the sebaceous glands connected to the eyelashes. Secretions from these glands lubricate the eyelid surface

Answer 1

Gland of Zeis

Question 2

What are the oil glands along the edge of the eyelids where the eyelashes are found.

Answer 2

Meibomian glands

Question 3

(a) Acute infection that usually involves Staphylococcus species.
1) External (abscess of gland of Zeis on lid margin, classic “stye”)
a) Usually is smaller and on the margin
2) Internal (abscess of meibomian gland)
a) Abscess that usually points onto the conjunctival surface of the lid.

Answer 3

Hordeolum

Question 4

What type of Hordeolum
abscess of gland of Zeis on lid margin, classic “stye
-Usually is smaller and on the margin

Answer 4

External

Question 5

What type of Hordeolum
abscess of meibomian gland
-Abscess that usually points onto the conjunctival surface of the lid

Answer 5

Interna

Question 6

What is a chronic focal granulomatous inflammation within the eyelid secondary to the obstruction of a meibomian gland or gland of Zeis (hordeolum).

Answer 6

Chalazion

Question 7

From PE what would you expect?

(a) Hard and nontender nodule on the eyelid
1) usually develops farther back on the eyelid than a hordeolum
(b) Edema on the upper or lower lid
(c) Erythema and edema of the adjacent conjunctiva.

Answer 7

Chalazion

Question 8

From PE what would you expect?

(a) Localized eyelid tenderness, swelling and erythema
(b) May have foreign body sensation depending on location
(c) Visible, or palpable, well-defined subcutaneous nodule in the eyelid
(d) May also note “pointing” of mucopurulent material
(e) Associated blepharitis or acne rosacea.

Answer 8

Hordeolum

Question 9

Differential Diagnosis for Hordeolum or chalazion

Answer 9

(1) Hordeolum (if chalazion) or chalazion (if hordeolum)
(2) Blepharitis
(3) Cellulitis

Question 10

What are some risk factors for these issues?

Answer 10

(1) Touch eyes with unwashed hands.
(2) Insert contact lenses without thoroughly disinfecting them or washing their hands first.
(3) Leave on makeup overnight.
(4) Use old or expired cosmetics.
(5) Have blepharitis, a chronic inflammation along the edge of the eyelid.

Question 11

TX for Hordeolum and Chalazion?
True/False
Patient should be encouraged to pop or squeeze the lesion to express it, decreasing the length of time they have this issue.

Answer 11

FALSE

Do NOT squeeze or pop a Hordeolum/Chalazion

Question 12

TX for Hordeolum and Chalazion?
True/False
Patient should discontinue eye makeup

Answer 12

True

Question 13

What are some things your patient can do at home to treat hordeolum or chalazion?

Answer 13

• Warm compresses, which are placed on the face for about 15 minutes four times a day.
• Massage and gentle wiping of the infected eyelid after the warm compress can also aid in drainage

Question 14

When should you give antibiotics for a hordeolum or chalazion?

What antibiotic would you give?

Answer 14

• If there is concern of patient developing periorbial cellulitis
• Bactrim BID for 5-7 days