Ophthalmology - Eyelid Disorders Flashcards
What is blepharitis?
Inflammation of the eyelid margins
Associated with dysfunction of Meibomian glands
Can lead to styes and Chalazions
How does blepharitis present?
Gritty, itchy and dry sensation in the eyes
What is a Stye?
Hordeolum externum
Infection of the glands of Zeis or glands of Moll
Red bump along eyelid
Can contain pus
Hordeolum internum
Infection of Meibomian glands
Deeper
More painful
Can point inwards towards the eyeball under the eyelid
How are styes treated?
Hot compresses
Analgesia
Good eye hygiene
When are topical antibotics used for styes?
Considered if associated with conjunctivitis or persistent symptoms
What is a chalazion?
Meibomian cyst
Meibomian gland becomes blocked and swells
Presents with swelling in eyelid that is typically non tender (can still be tender)
How is a chalazion treated?
Warm compresses and gentle massage towards eyelashes
Encourages drainage
Rarely drainage can be needed
What is Entropion?
Eyelid turns inwards with lashes pressed against the eye
Same day referral if threat to sight
What does entropion lead to?
Corneal damage and ulceration
What is the initial management of entropion?
Taping eyelid down to prevent it turning inwards
Lubricating eye drops to prevent eye from drying out
What is the definitive management of entropion?
Entropion surgery
What is ectropion?
Eyelid turns outwards exposing the inner aspect
Typically affects the bottom lid
What does ectropion lead to?
Exposure keratopathy
As the eye is exposed and not lubricated adequately and protected
How is ectropion treated?
Lubricating eye drops
Severe cases may need surgery
Same-day referral to ophthalmology
What is trichiasis?
Inward growth of eyelashes
Pain
Corneal damage
Ulceration
How is trichiasis managed?
Remove affected eyelashes
Prevent eyelash regrowth
- Electrolysis
- Cryotherapy
- Laser treatment
Same-day referral if risk to sight
What is periorbital cellulitis also called?
Preseptal cellulitis
What is periobital cellulitis?
Eyelid and skin infection in front of the orbital septum
How does preseptal cellulitis present?
Swollen, red, hot skin around eyelid and eye
What must be differentiated from preseptal cellulitis?
Orbital cellulitis
Sight and life-threatening
Patients must be referred for assessment
CT scan can help distinguish
How is preseptal cellulitis treated?
Systemic antibiotics
(oral or IV)
Preorbital can develop into orbital, so vulnerable patients e.g. children can need monitoring
What is orbital cellulitis?
Infection around the eye involving tissues behind the orbital septum
How does orbital cellulitis present?
- Pain with eye movement
- Reduced eye movements
- Visual changes
- Abnormal pupil reactions
- Proptosis (bulging forward of the eye)
How is orbital cellulitis treated?
Emergency admission
IV antibiotics
Surgical drainage can be needed if abscess forms
