Wk 15: Minor eye conditions (eyelid disorders, eyelid hygiene, dry eye syndrome)

Question 1

What are the examples of eyelid disorders?

Answer 1

• Stye (1 eye) resolve w/in 2-3 days
• Blepharitis
• Meibomian cyst: hard painless lump under eyelid, resolves spontaneously

Question 2

What is blepharitis?

Answer 2

• Inflammation of eyelid margin
• Chronic
• Bilateral

Question 3

What are the anatomical classifications of blepharitis?

Answer 3

• Anterior: base of lashes
• Posterior: meibomian glands

Question 4

What are the classifications of blepharitis by clinical symptoms?

Answer 4

• Staphylococcal blepharitis
• Seborrhoeic blepharitis
• Meibomian gland dysfunction

Question 5

What is staphylococcal blepharitis?

Answer 5

• Affects anterior eyelid margin
• Lash collarettes crusting
• Lid ulceration
• Folliculitis

Question 6

What is seborrhoeic blepharitis?

Answer 6

• Affects anterior eyelid margin
• Caused by: excessive sebum

Question 7

What is meibomian gland dysfunction?

Answer 7

• Posterior eyelid margin
• Associated w/ seborrhoeic dermatitis + rosacea

Question 8

What are the symptoms of blepharitis?

Answer 8

Intermittent + bilateral:

• Sore eyelids
• Gritty
• Dry eyes (blurred vision + contact lense intolerance)
• Eyelids sticking together (morning = infection)

Question 9

What are the signs of blepharitis?

Answer 9

• Swollen eyelids: staph + meibomitis
• Inflamed lid margins + conjunctiva
• Eyelid surface scaly, oily or greasy

Question 10

What are the counselling points for blepharitis?

Answer 10

• Chronic
• lid hygiene
• Contacts lenses avoided

Question 11

What is the management for blepheritis?

Answer 11

• Eyelid hygiene (1st line)
• Treat infection: topical chloramphenicol or fusidic acid

Question 12

When do you refer for blepheritis?

Answer 12

• Rosacea
• Seborrhoeic dermatitis
• Atopic eczema

Question 13

What are the eyelid hygiene counselling points?

Answer 13

• Warm compress to eyelid 5-10 mins
• Lid massage (espresses content)
• Cleanse eyelid twice
• Daily cleansing

Question 14

How do you cleanse the eyelid?

Answer 14

• Teaspoon of sodium bicarbonate + boiled water

OR

• Diluted baby shampoo + warm water w/ clean cloth

OR

• Boiled water for contact lens wearers

Question 15

What is dry eye syndrome (kerato-conjunctivitis sicca)?

Answer 15

• Disorder of tear film due to tear deficiency or excessive evaporation
• Damage to ocular surface

Question 16

What is dry eye syndrome aggravated by?

Answer 16

• Dry air
• Wind
• Dust
• Smoke

Question 17

What is the pathogenesis of dry eye syndrome?

Answer 17

• Secrete + clear tears: Ocular surface, tear secreting glands, meibomian glands + lid function
• Dysfunction of components = unstable + unrefreshed tear film

Question 18

What is the composition of tears?

Answer 18

• Water
• Lipids
• Salts
• Mucins
• Immunoglobulins
• Antimicrobial proteins
• Growth factors

Question 19

What is the structure of tears?

Answer 19

• Inner: mucins adhere to corneal epithelium
• Middle: aqueous/mucin phase
• Outer: lipids

Question 20

What are tears produced by?

Answer 20

• Inner + outer: lacrimal glands, ocular surface epithelium + conjunctival goblet cells
• Outer: meibomian glands

Question 21

Which is gender is dry eye syndrome most likely to be found in?

Answer 21

Women

Question 22

What are the symptoms of dry eye syndrome?

Answer 22

• Both eyes affected
• Irritation + soreness
• Contacts poorly tolerated
• Vision transiently affected due to loss of surface moisture
• Photophobia

Question 23

What is the treatment + management for dry eye syndrome?

Answer 23

Artificial tears (hypromellose 0.3% eye drops):

• 30 min intervals if symptoms severe
• Preservative free preps if 6 applications per day
• Benzalkonium chloride = risk of ocular irritation

Question 24

What are lubricants and when are they used?

Answer 24

• Eye ointment w/ paraffin/paraffin + lanolin
• Bedtime bc prolonged lubrication
• Not morning bc blurred vision
• Remove contacts prior to use
• Contacts replaced in morning