Wk 15: Minor eye conditions (eyelid disorders, eyelid hygiene, dry eye syndrome) Flashcards
What are the examples of eyelid disorders?
- Stye (1 eye) resolve w/in 2-3 days
- Blepharitis
- Meibomian cyst: hard painless lump under eyelid, resolves spontaneously
What is blepharitis?
- Inflammation of eyelid margin
- Chronic
- Bilateral
What are the anatomical classifications of blepharitis?
- Anterior: base of lashes
- Posterior: meibomian glands
What are the classifications of blepharitis by clinical symptoms?
- Staphylococcal blepharitis
- Seborrhoeic blepharitis
- Meibomian gland dysfunction
What is staphylococcal blepharitis?
- Affects anterior eyelid margin
- Lash collarettes crusting
- Lid ulceration
- Folliculitis
What is seborrhoeic blepharitis?
- Affects anterior eyelid margin
- Caused by: excessive sebum
What is meibomian gland dysfunction?
- Posterior eyelid margin
- Associated w/ seborrhoeic dermatitis + rosacea
What are the symptoms of blepharitis?
Intermittent + bilateral:
- Sore eyelids
- Gritty
- Dry eyes (blurred vision + contact lense intolerance)
- Eyelids sticking together (morning = infection)
What are the signs of blepharitis?
- Swollen eyelids: staph + meibomitis
- Inflamed lid margins + conjunctiva
- Eyelid surface scaly, oily or greasy
What are the counselling points for blepharitis?
- Chronic
- lid hygiene
- Contacts lenses avoided
What is the management for blepheritis?
- Eyelid hygiene (1st line)
- Treat infection: topical chloramphenicol or fusidic acid
When do you refer for blepheritis?
- Rosacea
- Seborrhoeic dermatitis
- Atopic eczema
What are the eyelid hygiene counselling points?
- Warm compress to eyelid 5-10 mins
- Lid massage (espresses content)
- Cleanse eyelid twice
- Daily cleansing
How do you cleanse the eyelid?
- Teaspoon of sodium bicarbonate + boiled water
OR
- Diluted baby shampoo + warm water w/ clean cloth
OR
- Boiled water for contact lens wearers
What is dry eye syndrome (kerato-conjunctivitis sicca)?
- Disorder of tear film due to tear deficiency or excessive evaporation
- Damage to ocular surface
What is dry eye syndrome aggravated by?
- Dry air
- Wind
- Dust
- Smoke
What is the pathogenesis of dry eye syndrome?
- Secrete + clear tears: Ocular surface, tear secreting glands, meibomian glands + lid function
- Dysfunction of components = unstable + unrefreshed tear film
What is the composition of tears?
- Water
- Lipids
- Salts
- Mucins
- Immunoglobulins
- Antimicrobial proteins
- Growth factors
What is the structure of tears?
- Inner: mucins adhere to corneal epithelium
- Middle: aqueous/mucin phase
- Outer: lipids
What are tears produced by?
- Inner + outer: lacrimal glands, ocular surface epithelium + conjunctival goblet cells
- Outer: meibomian glands
Which is gender is dry eye syndrome most likely to be found in?
Women
What are the symptoms of dry eye syndrome?
- Both eyes affected
- Irritation + soreness
- Contacts poorly tolerated
- Vision transiently affected due to loss of surface moisture
- Photophobia
What is the treatment + management for dry eye syndrome?
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
What are lubricants and when are they used?
- Eye ointment w/ paraffin/paraffin + lanolin
- Bedtime bc prolonged lubrication
- Not morning bc blurred vision
- Remove contacts prior to use
- Contacts replaced in morning
