Quiz eye part 1 Flashcards
Disorders affecting the eyelids
blepharitis, anterior, posterior, hordeolum, chalazion, entropion and extropion
Blepharitis
-recurrent disorder that involves chronic inflammation of the eye lid margins
s and s of blepharitis
dry eyes, burning, itching, light sensiticity, sandy gritty sensation, discomfort, redness, tearing
where can bleph be
anterior or posterior eye lid
anterior bleph
-eye lashes and sebaceous glands of zeiss
-affects the outside front of the eyelid where the lashes are attached
posterior bleph
openings of the meibomian glands
2 most common anterior bleph strains:
staphylococcus and seborrheic dermatitis
what is a potential cause of bleph
dandruff falling from the scalp adn into the eye lid or a skin infeciton with s aur
anterior bleph staph infection
-scaling, matted, hard crusts around the eye lashes, difficulty opening the eye, removing the crust can leave small ulcers that bleed and ooze
-ddx: conjunctivitis
complication of ant bleph
-sty/ hordeolum can form becuase the gland is blocked and infected
anterior bleph treatment
warm compress, lid hygeine, antibio ointment (azith1%)
-if it is staph us a steroid to decrease inflammation
s and s of ant blep from serborrheic
greasy flakes and scales along eye lashes and lid margin and the pt will have seb. dermatititis
treatment of seb ant bleph
warm compress, eye lid scrub, baby shampoo
post bleph pathophys
-meibomian glands are not functioning and the glands are plugged by oily secretions
s and s post bleph
chronic red irritated eyes, common in pt with acne rosacea or seb dermatitis
post bleph tx
warm compress, lid scrib, bactracin/ erythromycin eye ointment, oral tetracycling *cant if they are under 18 and topical corticosteroids (if severe)
what is a hordeolum
-red, infected, localized lump that is filled with pus
-usual pathogen: s aur
-can be exeternal or internal
external hord
caused by a blockage and infection of a ciiary follicle adn the adjacent sebaceous glands of moll or zeis (on the eyelash but outside)
internal hord
due to a blockage and infection of the meibomian sebaceious glands in the tarsal plate (inside the eyelid)
*can damage the cornea
hord onset
acute, painful, red, localized swellings with abscesss formation (this can spread), can also lead to generalized cellulitis of the lid and self limiting once it drains
hord tx
warm compress, soaks, if does not resolve 48 hours may need incision
is a chalazion painful
no, but if you have it for a while it will be firm and hard
what is a chalazion
a focal chronic inflammatory lesion of the eyelid due to obstruction of a sebacious gland, this often follows an internal hord
-it is slow growing painless nodule
are lipogranulomas in chalazion infected
no bc they are lipids in the tissue
chalazion time line
can lasts for months, red swollen, treat with warm compress 4x a day
can steroid injection be for chalazion
yes IF there is no infection and or no response to treatment
what causes angioedema
an allergic rx, no scaling
causes angioedema
exposure to allergens
angioedema tx
self limiting, avoid inciting agents like ace inhibitors, if the airway is obstructed this is an emrgency= IM epi, mild case: oral antihistamines or glucocorticoids
types of cellulitis
pre vs post (proptosis)
cellulitis s and s
severe edema, deep violaceous color, pain
cellulitis onset
days to hours, preceded by upper respiratory tract infection, local skin trauma, abscess, insect bite or impetigo, sinusitis
proptosis
decreased visual aquity, pain with eye movmement, limited extraocular mvoement and afferent papillary defect
-eye is pushed out
preseptal cellulitis
0out patient, broad spectrum antibiotic (diclo or augmentin) and close follow up
-under the age of 4= hospital
orbital/ post septal cellulitis
elevated WBC, CT, unasyn (ampicillin/subactam),
Entropion
-inside
-inward tuning of the eye lid
-can scratch and scar the cornea and may following scarring of the conjunctiva and tarsus which is common with age
entropion rx
botulinum toxin injection
ectropion
-outside turning of the lower lid
-common with age as you lose elasticity
-treat with surgery
-if the tearing is excessive (epiphora) there could be exposure keratitis or cosmetic problem
Pinguecula
-yellow elevated nocule on either side of the cornea
-this is benign
-common on the nasal side
-age> 35 years and they rarely grow
-inflammation
pinguecula tx
-artificial tears, short course of nsaids or weak steroid
pterygium
-fleshy triagular are on the conjunctive
-nasal side of the cornea
-constant wind, sun, dust exposure can cause this
-unilateral or bilateral
pterygium tx
-sunglasses, artificial tears, nsaids or weak steroid
-excision bc the growth is interfering with vision when it grows and cover the cornea
Dacrocystitis vs dacroadenitis
-adenitis= gland
-cystitis= sac
dacrocystitis
-can have an infection of the lacriminal gland or sac due to obstructionof the nasolacrimal system
-can be related to malformation of the tear duct, injury, eye infection or trauma
-infants to middle age
-unilateral
dacrocystisis s and s
epiphora and discharge, tenderness, redness and swelling
-acute
dacrocystitis causes
-staph aur, beta hemolytic strep, anaerobes, candida, will respond well to abx
dacrocystitis cure
relief of the obstruction
-dacryocystirhinostomy
foreign body presentation
-pt feels something in the eye
-fb will be in the cornea and conjunctiva
-rust ring (from steel FB)
Treat FB
-local anesthetic, record visual acuity recorded, fluorescien, polumyxin, bacitracin opthalmic ointment, tissue excised under local anesthetia using slit lamp, FB removed with applicator
-follow up 24 hours
corneal abrasion
-fingernail, paper, contact lense, pain, photophobia, tearing, blepharospasm, FB sensation
