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Ocular Disease > Midterm 2- Hordeolum/ chalazian cysts > Flashcards

Midterm 2- Hordeolum/ chalazian cysts Flashcards

1
Q

External hordeolum

A

Infection of a Zeiss gland

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2
Q

Internal hordeolum

A

Infection of a meibomian gland

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3
Q

main cause of hordeolum

A

Staphylococcus aureus is the infectious agent in 90-95% of cases of hordeolum
Abscess (“Bag of pus”) -

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4
Q

Hordeolum subjective

A
  • Patients usually complain of a localized painful swelling on one eyelid
  • In some cases, the complaint may start as a generalized edema and erythema of the lid that later becomes localized.
  • A history of similar problems is common.
  • Constitutional signs and symptoms are inconsistent with a hordeolum diagnosis
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5
Q

Hordeolum

Epidemiology:

A

-Found more frequently in persons who have
Diabetes
Other debilitating illness
Chronic blepharitis
Seborrhea
-High serum lipids (High lipid levels increase the blockage rate of sebaceous glands, but lowering of serum lipid levels in these patients has not decreased frequency of recurrence.)

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6
Q

External Hordeolum

A

Localized, raised, red bump near lid margin
Tender to touch
“Points” to skin side of lid

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7
Q

Hordeolum associated with

A

Hordeolum associated with staphylococcal blepharitis

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8
Q

external Hordeolum tx

A
  • No treatment; usually are self-limited
  • -Most eventually point and drain by themselves
  • -Discharge anteriorly, close to the lashes

Warm soaks (qid for 15 min) are the mainstays of treatment

  • Topical antibiotics may be used for recurrent lesions and for those that are actively draining
  • Epilation of eyelash associated with infected follicle
  • -May enhance drainage of pus
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9
Q

Internal Hordeolum

A

Localized, red, raised bump
Tender to the touch
Points to the conjunctival side of the lid

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10
Q

internal Hordeolum

infections

A
  • Large internal hordeolum discharging anteriorly through skin
  • Infection can spread from the gland to the lid connective tissue preseptal cellulitis
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11
Q

Hordeolum tx

A
  • Usually are self-limited
  • Most eventually point and drain by themselves.
  • Warm soaks (qid for 15 min) are the mainstays of treatment.
  • Topical antibiotics may be used for recurrent lesions and for those that are actively draining
  • Surgical drainage of pointed lesions can speed the healing process
  • Systemic antibiotics are indicated only when inflammation has spread beyond the immediate area of the hordeolum
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12
Q

internal

Drainage of a hordeolum

A
  • Stab incision at the site of pointing using an 18-gauge needle or a #11 blade
  • External incisions lead to scarring, so making external eyelid incisions or punctures is inadvisable, unless the hordeolum already is pointing externally
  • A large abscess may have multiple pockets and require multiple stabs.
  • Internal incisions should be made vertically to minimize the area of cornea swept by a scar during blinking
  • Leave the incision open with a clean margin
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13
Q

Chalazion

A
  • AKA meibomian cyst
  • Lipogranulomatous infiltration of meibomian gland
  • May follow an internal hordeolum
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14
Q

chalazion Signs

A
  • Firm nodule within tarsal plate
  • Non-tender, non-inflamed
  • Some refer to a internal hordeolum as an acute chalazion
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15
Q

Chalazion tx

A

Warm compresses
10-15 minutes
At least qid but q2h better
Work best if lesion is recent

Steroid injection into lesion
0.1-0.2 ml triamcinolone injected through conjunctiva

Incision and curettage
Local anesthetic
Chalazion clamp 
Incision from conjunctival side
Curettage - scrape out material
Topical antibiotic ointment - X 2 days
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16
Q

Cyst of Moll

A

AKA suderiferous cyst or apocrine hidrocystoma

Arises from a blocked sweat-secreting gland associated with the cilia (gland of Moll)

17
Q

Cyst of Moll features

A 
Dome shaped
Non-tender
No inflammation
Translucent
Fluid-filled
Anterior lid margin
18
Q

Poliasis-

A

white lash

19
Q

Cyst of Moll tx

A
  • Primarily a cosmetic concern
  • Can aspirate with a fine needle but recurrence is common
  • Excision with removal of the sac to avoid recurrence
20
Q

Cyst of Zeiss

A
  • Arises from a blocked oil-secreting gland associated with the cilia (gland of Zeiss)
  • Contains oily secretions and is less translucent than a cyst of Moll
21
Q

Sebaceous Cyst

A
  • Forms when an oil gland in the skin is blocked
  • Can be found on any part of the body
  • Yellowish-white lumps on the skin
  • -Have a central punctum
  • If squeezed, exude a stringy, cheesy white material
22
Q

Sebaceous Cyst tx

A
  • Primarily a cosmetic problem
  • The total sac of the cyst must be removed
  • If the cheesy material is just squeezed out, the cyst will reform
  • In the case of an infected cyst, an oral antibiotic should be prescribed
23
Q

Sebaceous Cyst prevention

A

Good hygiene may prevent the formation of sebaceous cysts

Some individuals are predisposed to development of these cysts, so even careful hygiene does not prevent them

Ocular Disease (7 decks)

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