Ophthalmology - Eyelids/Oculoplastics Flashcards
What is orbital cellulitis?
Infection around the eyeball that involves tissues behind the orbital septum → life threatening emergency!
What are the 3 important features that distinguishes orbital cellulitis from preseptal/periorbital cellulitis?
- Pain on eye movement
- Diplopia
- Visual impairment
What is preseptal cellulitis?
This is an eyelid and skin infection in front of orbital septum (does not spread past orbital spectrum).
Give some features of orbital cellulitis
- Pain on eye movement
- Diplopia
- Visual impairment
- Reduced eye movements
- Abnormal pupil reactions
- Proptosis
- Fever
1st line imaging in orbital cellulitis?
CT scan
Management of orbital cellulitis?
- IV antibiotics
- ?surgical drainage
How can orbital cellulitis lead to vision loss?
Due to compression of optic nerve or optic neuritis
How can orbital cellulitis lead to death?
Due to cavernous sinus thrombosis or intracranial spread of infection
What is the cause of preseptal cellulitis?
Sinusitis or damage to overlying skin.
Typical presentation of preseptal cellulitis?
Child with erythematous swollen eyelid, mild fever and erythema surrounding the orbit.
What is another name for a chalazion?
Meibomian cyst
What causes a Meibomian cyst?
Occurs when a Meibomian gland becomes blocked and swells up (non-infectious).
Presentation of a Meibomian cyst?
Swelling in eyelid – typically not tender (but can be tender and red).
Management of a chalazion?
Hot compresses and eyelid cleaning regularly indefinitely plus simple eye lubricants (tend to resolve in a few weeks)
What is a stye?
Abscess at an eyelash follicle often caused by staphylococcus.
What pathogen typically causes a stye?
Staphylococcus
Presentation of a stye?
‘Red hot lump’ that points outwards, causing pain and local inflammation.
What is another name for a stye?
External Hordeolum
What is blepharitis?
Inflammation of the eyelid margins.
Which dermatological condition is often associated with blepharitis?
Acne rosacea
Cause of blepharitis?
Can be associated with dysfunction of Meibomian glands (responsible for secreting oil onto surface of eye).
Presentation of blepharitis?
- Sore, itchy eyelid margins with a crusty appearance at base of eyelashes
- ‘Gritty’ sensation in eyes
What can blepharitis lead to?
Can lead to styles and chalazions.
Management of blepharitis?
Lubricating eye drops e.g. Hypromellose
What is a blocked nasolacrimal duct?
Blocked tear duct means tears can’t drain normally.
Who does a blocked nasolacrimal duct typically present in?
Newborns - usually resolves in first year of life
Presentation of a blocked nasolacrimal duct?
- Watery, irritated eye
- Dacrocystitis – inflammation of the lacrimal sac 2ary to obstruction within the duct, causing the backup and stagnation of tears
What is dacrocystitis?
inflammation of the lacrimal sac 2ary to obstruction within the duct, causing the backup and stagnation of tears
What is the most common type of skin cancer of the eyelid?
Basal cell carcinoma (often appears in lower lid)
Where does sebaceous carcinoma of the eyelid arise from/
Meibomian glands
