Ophthalmology - Eyelid Disorders

Question 1

What is belpharitis?

Answer 1

Inflammation of the eyelid margins

Associated with dysfunction of Meibomian glands

Can lead to styes and Chalazions

Question 2

How does blepharitis present?

Answer 2

Gritty, itchy and dry sensation in the eyes

Question 3

What is a Stye?

Answer 3

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

Question 4

How are styes treated?

Answer 4

Hot compresses
Analgesia

Question 5

When are topical antibotics used for styes?

Answer 5

Considered if associated with conjunctivitis or persistent symptoms

Question 6

What is a chalazion?

Answer 6

Meibomian cyst
Meibomian gland becomes blocked and swells

Presents with swelling in eyelid that is typically non tender (can still be tender)

Question 7

How is a chalazion treated?

Answer 7

Warm compresses and gentle massage towards eyelashes

Encourages drainage

Rarely drainage can be needed

Question 8

What is Entropion?

Answer 8

Eyelid turns inwards with lashes pressed against the eye

Same day referral if threat to sight

Question 9

What does entropion lead to?

Answer 9

Corneal damage and ulceration

Question 10

What is the initial management of entropion?

Answer 10

Taping eyelid down to prevent it turning inwards

Lubricating eye drops to prevent eye from drying out

Question 11

What is the definitive management of entropion?

Answer 11

Entropion surgery

Question 12

What is ectropion?

Answer 12

Eyelid turns outwards exposing the inner aspect

Typically affects the bottom lid

Question 13

What does ectropion lead to?

Answer 13

Exposure keratopathy

As the eye is exopsed and not lubricated adequately and protected

Question 14

How is ectropion treated?

Answer 14

Lubricating eye drops

Severe cases may need surgery

Same-day referral to ophthalmology

Question 15

What is trichiasis?

Answer 15

Inward growth of eyelashes

Pain
Corneal damage
Ulceration

Question 16

How is trichiasis managed?

Answer 16

Remove affected eyelashes

Prevent eyelash regrowth
- Electrolysis
- Cryotherapy
- Laser treatment

Same-day referral if risk to sight

Question 17

What is periorbital cellulitis also called?

Answer 17

Preseptal cellulitis

Question 18

What is periobital cellulitis?

Answer 18

Eyelid and skin infection in front of the orbital septum

Question 19

How does preseptal cellulitis present?

Answer 19

Swollen, red, hot skin around eyelid and eye

Question 20

What must be differentiated from preseptal cellulitis?

Answer 20

Orbital cellulitis
Sight and life-threatening

Patients must be referred for assessment

CT scan can help distinguish

Question 21

How is preseptal cellulitis treated?

Answer 21

Systemic antibiotics
(oral or IV)

Preorbital can develop into orbital, so vulnerable patients e.g. children can need monitoring

Question 22

What is orbital cellulitis?

Answer 22

Infection around the eye involving tissues behind the orbital septum

Question 23

How does orbital cellulitis present?

Answer 23

• Pain with eye movement
• Reduced eye movements
• Visual changes
• Abnormal pupil reactions
• Proptosis (bulging forward of the eye)

Question 24

How is orbital cellulitis treated?

Answer 24

Emergency admission

IV antibiotics

Surgical drainage can be needed if abscess forms