Ophthalmology 8 - Eyelid Disorders

Question 1

blepharitis - what is it + treat it

Answer 1

inflammation of the eyelid margins

gritty dry eye sensation

can lead to styes

hot compress+gentle cleaning
lubricating eye drops
(start with polyvinyl alcohol, hypromellose least viscous and most temporary, carbomer drops most viscous and last an hour)

Question 2

what is a stye / how to treat it

Answer 2

‘hordeolum’

can be externum (infected glands of Zeis/Moll)

or internum (Meibomian gland infection, deeper and more painful)

hot compress, pain relief

Question 3

what is a chalazion + how is it treated?

Answer 3

blocked and swollen Meibomian gland, also called Meibomian cyst

presents with eyelid swelling, usually not tender

hot compress, pain relief

Question 4

entropion define + treat

Answer 4

inwardly turned eyelid with lashes against eyeball

can cause corneal damage + ulceration

tape the eyelid down+use eye drops to lubricate

definitive intervention is surgical

Question 5

what to do if worried about risk to sight in a patient?

Answer 5

same day ophthal referral

Question 6

define ectropion + treat

Answer 6

outwardly turned eyelid with pink side exposed
usually bottom lid

can cause exposure keratopathy

lubricating eyedrops

if severe, surgery to correct

Question 7

define trichiasis and treat

Answer 7

inward growth of eyelashes

pain, corneal damage/ulcers

specialist to carry out epilation (eyelash removal)

recurrence: electrolysis, cryotherapy, laser

Question 8

define periorbital cellulitis

Answer 8

eyelid and skin infection in front of the orbital septum

swelling, redness, hot skin around area

crucially must exclude orbital cellulitis which is a threat to sight

systemic IV abx

Question 9

define orbital cellulitis

Answer 9

emergency

tissues involved beyond orbital septum

pain on eye movement, reduced eye movements, vision change, abnormal pupil reactions, proptosis

IV abx +/- surgical drainage

kids/vulnerable more likely to develop from preorbital