Week 5 Flashcards

1
Q

Chalazion symptoms

A
  • Painless lump
  • Recurrent disease
  • Gradual onset
  • Blurred vision
  • History of internal hordeolum
  • Conjunctival granuloma
  • Chronic
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1
Q

Chalazion

A
  • Inflammatory and sterile not infectious
  • Caused by the blockage of secretary gland the meiobian gland and zeis and moll
  • Following acute infection such as internal haredolum
  • Risk factors are chronic blepharitis, pregnancy and diabetes
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2
Q

Chalazion signs

A
  • Well defined solid nodule on tarsal plate
  • Eyelid eversion reveals conjunctival granuloma
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3
Q

Chalazion management

A
  • Warm compression and hot spoon on closed eye
  • Lid massage, breaks down the granulation
  • Management of underlying disease chronic blepharitis
    Reassurance and advice
  • Advice them it will take weeks/ months to resolve
  • not an infection so can not take antibiotics
  • If lump is large and interfering with vision might have to steroid infection
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4
Q

Hordeolum

A

Infection of glands - acute staphyloocal
red and tender
- Predisposing factors chronic blepharitis
- Infection of the meiobian gland
- Zeis and moll and eyelash follice infection

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5
Q

Hordeolum symptoms

A
  • Tender lump
  • Redness and swelled eyelid
  • Epiphoria
  • On the lid
  • Hot to touch
  • Painful
  • Acute onset
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6
Q

Hordeloum Signs

A

Tender inflamed area of the lid/ tarsal plate caused by infection and inflammation anterior pointing posteriorly through the conjunctiva and skin

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7
Q

Hordeloum advice

A
  • Warm compresses and hot spoon
  • Epilation of eyelashes
  • Management of undelying disease chronic blepharitis
    Advice
  • It will take 1-2 weeks to resolve
  • Internal hordeolum may turn into chalazion
  • If discharge continues and no improvement give antibiotics to take 1 time day for 7 days
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8
Q

Ectropian

A
  • Outward rotation of the eyelid margin
  • Predosping by age increase in laxity
  • Mostly bilateral about 70%
    Causes
  • Cicatricial caused by trauma, burn or surgery
  • invulation cause by older age as there is increase lid laxity and the eye muscles and tendons begin to weaken
  • Parcytical nerve innervation problem to the eyelid muscle
  • congenital, genetics, rare
  • Mechanical, due to a trauma causing obstruction in or around the eye
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9
Q

Ectropian Symtoms

A
  • Painful, discomfort and sign
  • Redness
  • Excessive lacrimation
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10
Q

Ectropian signs

A
  • Lower lid no longer against the globe
  • Abnormal attachment of the pauncta, visible all the time with no force pulling the eye
  • Conjunctival hyperaemia, redness of the conjunctiva
  • Exposure keratopathy exposure of the cornea causes epithelium damage due to excessive tears reaching and moistening it
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11
Q

Ectropian management

A
  • Reassurance and advice caused by rubbing of the eyelids increase in laxity
  • Ocular lubricants

For Manage keratitis
- Tap the lip close to reduce exposure
- Theraputic contact lenses
- Ocular lubricants

Where significant corneal involvement and risk of infectious keratitis
- urgent referral to the ophthalmologist
- Consider for surgery

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12
Q

Ectropian magnitude test

A

Snap back and distraction test can be done to measure the magnitude of ectropian
- snap back test, poor recovery means poor ocularis tone
- Distraction test, pull the eyelid down
lax>6mm

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13
Q

Floppy eyelid syndrome

A
  • Not too common
  • Symptoms presenting worse in the morning, gretty eyes, dry eyes
  • Common on middle aged and obese men
  • Easy eyelid eversion
  • Abnormal snap back and distraction test
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14
Q

Entropian

A
  • Tarsal and eyelid margin rotate inwards
  • Predesposing factors, older age and cicatrising disease of conjunctival tarsal
    Causes
  • Congenital, abnormal attachtment between the rector muscle and inferior tarsal plate
  • Cicatrsial, scarring and contraction of the palpebral conjunctival tissue pulls the eyelid margin inwards
  • Invulation, agre related degeneration atrophy of tarsal which supports the structure of the eye
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15
Q

Entropian symptoms

A
  • Irritation
  • Grittiness
  • Blurrned vison
  • Redness
  • Lacrimation
16
Q

Entropian signs

A
  • Conjunctival scarring
  • Conjunctival hyperaemia
  • Absence of lower lid crease
17
Q

Entropian mag test

A
  • snap back and distraction test
18
Q

Entropian management

A
  • Tapping lid to cheek provides temporary relief
  • Ocular lubricatnts
  • Epilation of eyelashes associated
  • Theraputic contact lenses
  • Referral for surgery if rucurrent infection
19
Q

Trichiasis

A
  • Misdirection of lashes, growth in direction of the ocular surface
    Cause
  • Congenital, failure of epithelial cell to differentiate completely to meiobiam gland
  • Acquired, abnormal growth of the eyelid tissue following after an injury

Predisposing factors
- Staphyloccal blepharitis
- HZO

20
Q

Trichiasis symptoms

A
  • Discomfort/ foreign body sensation
  • Lacrimation
  • Hyperaemia
21
Q

Trichiasis signs

A
  • Rubbing of the lashers on the ocular surface
  • Conjunctival redness
  • Corneal epithelial abrasion
  • Stain with flourasciene and check ocular surface
    Severe sign
  • Corneal ulcer and infective keratitis due to constant rubbing of the eyelashes on the ocular surface and transferring infection
22
Q

Trichiasis management

A
  • Epilation, removal of troublesome lashes using forcep and sterile tweezer
  • Therapeutic contact lenses
  • Manage underlying cause such as blepharitis and or entropian
  • Ocular lubricants at day time and ointment at night

Referral in severe cases with significant corneal involvement
- Electrolysis
- Laser photocoagulation