Ears/Eyes Flashcards

Question

Otosclerosis

Answer 1

Genetic (autosomal dominant) metabolic bone disease affecting otic capsule and ossicles, leads to overgrowth of footplate in stapes/dysfunction F>M 2:1; much more common in whites, most commonly appears 15-35 yrs. SSxs: Progressive bilateral (conductive) hearing loss and tinnitus (occasionally, vertigo)

Answer 2

Sclerosis of TM: from chronic OM, post T-tube Leads to stiffening of the tympanic membrane and impaired conductive hearing SSxs: early asymptomatic, but hearing loss progresses PE: Whitish plaques on TM (areas of hyalinization with deposition of calcium and phosphate crystals)

Answer 3

Peripheral vestibular disorder - Sudden unilateral hearing loss and severe vertigo, frequently assoc nausea and vomiting Patient is often bedridden while the symptoms gradually subside. Vertigo eventually resolves after several days to wks; however, unsteadiness and positional vertigo and hearing loss may persist URI precedes the onset of symptoms in up to 50% of cases Can result from reactivation of a latent varicella-zoster virus infection, yrs after the primary infection (Herpes Zoster Oticus – Ramsay-Hunt syndrome) Adults aged 30-60 years, rarely observed in children. PE: spontaneous nystagmus towards the normal side with diminished or absent caloric responses in the affected ear. hearing loss: mild to moderate, often higher frequencies (>2000 Hz) SSxs: initial deep, burning, auricular pain followed a few days later by the eruption of a vesicular rash in the external auditory canal and concha. Vertigo, hearing loss, and facial weakness may follow

Answer 4

Peripheral vestibular disorder caused by either direct bacterial invasion (suppurative labyrinthitis) or through the passage of bacterial toxins into the inner ear (serous labyrinthitis). - meningitis typically affects both ears. Bacteria spread from the cerebrospinal fluid to the membranous labyrinth by way of the internal auditory canal or cochlear aqueduct. - infections of the middle ear or mastoid most commonly spread to the labyrinth through a dehiscent horizontal semicircular canal. Usually, the dehiscence is the result of erosion by a cholesteatoma. SSxs: profound hearing loss, severe vertigo, ataxia, and nausea and vomiting Now rare in the post-antibiotic era

Answer 5

Peripheral vestibular disorder - benign and temporary disorder of the vestibular nerve resulting in vertigo NOT assoc with hearing loss more common in the fourth and fifth decades of life . M=F URI often precedes. More common in the spring and early summer, commonly viral SSxs: sudden acute vertigo without hearing loss in an otherwise healthy patient. PE: horizontal nystagmus may be present, some gait instability, NO hearing loss

Answer 6

Peripheral vestibular disorder - sudden vertigo elicited by provocative positions, triggering nystagmus. The character and direction of the nystagmus are specific to the part of the inner ear affected and the pathophysiology Subclassified by location in semicircular canal (ie, horizontal, posterior, or superior) and pathophysiology (canalithiasis and cupulolithiasis) - canalithiasis (literally, "canal rocks") particles residing in the canal portion of the SCCs. These densities are free floating and mobile, causing vertigo by exerting a force. - cupulolithiasis (literally, "cupula rocks") refers to densities adhered to the cupula of the crista ampullaris. Cupulolith particles reside in the ampulla of the SCCs and are not free floating. BPPV is due to posterior semicircular canal canalithiasis ~ 90% of the time. Etiology: risk factors--inactivity, alcohol, caffeine, major surgery, and CNS disease. Idiopathic, head/ear trauma, otitis media, vestibular neuritis, Ménière disease, otosclerosis, SSNHL, acoustic neuroma, vertebral basilar insufficiency SSxs: Sudden onset: vertigo while trying to suddenly sit up, lying down, rolling over in bed, looking up. Symptoms start very violently and usually dissipate within 20 or 30 seconds Severe dizziness occurs as “attacks” some cases, even the slightest head movement causes N&V. Between episodes, patients usually have few or no symptoms. However, some patients complain of a continual sensation of a "foggy or cloudy" sensorium. In many, the symptoms periodically resolve and then recure PE: Generally unremarkable. Dix-Hallpike maneuver - standard clinical test for BPPV - rapidly move the patient from a sitting position to the supine position with the head turned 45° to the right. After waiting approximately 20-30 seconds, the patient is returned to the sitting position. If no nystagmus is observed, the procedure is then repeated on the left side. Vertigo and nystagmus seen in posterior canal dysfunction Positive test: classic rotatory nystagmus with delay and limited duration is considered pathognomonic.

Answer 7

Peripheral vestibular disorder Benign, slow growing tumor derived from Schwann cells of CN VIII SSxs: unilateral, progressive SNHL, Vertigo, tinnitus, disequilibrium can be concomitant Headaches are present in 50-60% of patients Facial numbness occurs in about 25% of patients A large tumor can compress the brainstem and affect other cranial nerves, inc intercranial pressure Consider any unilateral sensorineural hearing loss an acoustic neuroma until proven otherwise.

Answer 8

Peripheral vestibular disorder Increase in volume and pressure of the endolymph in the endolypmhatic spaces of inner ear. Typically occurs in early- to mid-adulthood; M=F Etiology: exact cause is unknown. Up to 50% of patients have a positive FHx SSxs: Triad - waxing and waning SN hearing loss, tinnitus, vertigo a. Prodrome: fullness or blocked sensation in one ear (like listening to shell) b. Tinnitus followed by a decrease in hearing (esp low pitches), nausea, vomiting, diarrhea, pallor, and sweating common with an acute attack c. Vertigo is experienced concurrently with or follows shortly after the hearing symptoms; typically lasts min to hrs but may last several days. d. headache and gait unsteadiness may persist for several days Course: following an acute episode, hearing may return to normal. Recurrence is common but unpredictable; hearing usually is decreased over time Tumarkin crises - patients may experience such severe vertigo that they will collapse to the ground. PE: complete neurological examination is necessary to R/O other conditions, esp. cranial nerve examination Vestibular maneuvers (Nylen-Bárány, Dix Hallpike) may be helpful in diagnosing this syndrome. DX: i. isolated attacks of whirling, vertigo usu with n/v for at least 20 min, up to several hrs ii. tinnitus - multipitched, multisounds, roaring, whistling: severe, unilateral, constant or fluctuating iii. sensory hearing loss (progressive) [10-15% are bilateral] DDX: migraine headache, hypothyroidism, labyrinthitis, multiple sclerosis, OM, ischemic stroke subarachnoid hemorrhage , TIA, vestibular neuritis, acoustic neuroma, salicylate toxicity

Answer 9

Central vestibular disorder from ingestion of various agents: Aminoglycoside antibiotics - creates bilateral vestibular damage, may have blurred vision while moving the head (eg streptomycin, gentamicin most vestibulotoxic; neomycin, kanamycin, tobramycin most auditory toxicity) Aspirin can produce dose-related reversible tinnitus, hearing loss, dizziness Alcohol produces reversible positional nystagmus

Answer 10

Migrainous vertigo, brainstem ischemia, multiple sclerosis, cerebellar infarct

Answer 11

Ask re rate of onset, pain or no, central or peripheral loss, uni- or bilateral DDX: Vision Loss

Answer 12

- Hyperopia (far-sightedness) - most common; distant objects are clear, and close-up objects blurry (shortened eyeball) - Myopia (near-sightedness) - faraway objects will appear blurry (elongated eyeball) - Astigmatism - refraction is unequal in different meridians of the eye; the cornea or the lens has a slightly different surface curvature. Often present at birth and may occur in combination with nearsightedness or farsightedness. - Presbyopia - a slow loss of ability to see close objects or small print. With age, the lens becomes less pliable and eventually cannot accommodate in response to the action of the ciliary muscles

Answer 13

color, quality, quantity, irritating? | Bacterial or viral conjunctivitis, allergic reaction

Answer 14

COMMON: always looking within 20' (prolonged reading or close work, computer screens) Sensation of tired eyes, increasing difficulty focusing or seeing, eye dryness, headache

Answer 15

Abnormal visual intolerance of light Causes: eye infection, eye injury, conjunctivitis, Allergies, Acute glaucoma, Cataracts, Migraine headache, Eye inflammation (uveitis, iritis, keratitis), Corneal disorder (foreign body, abrasion, ulcer)

Answer 16

Area of partial or complete blindness, usually within the central 30-degree area. From damage to nerve fiber layer in retina. Often seen by pt as “dark spot” “scintillating scotoma” - an irregular outline around a luminous patch in the visual field following mental or physical work, eyestrain or migraine prodrome (visual aura)

Answer 17

Deposits (various size, shape refractive index, and motility) within the eye's vitreous humor appear as “spots” or “threads” which slowly “float” Visible because of the shadows they cast on the retina or their refraction of the light that passes them Etiology: Developmental, acquired (degenerative changes in vitreous humor or retina) May be associated with autoimmune uveitis, diabetic retinopathy, posterior vitreous detachment (PVD) , and with aging

Answer 18

- Hemianopsia: blindness or decreased vision in half of visual field of one or both eyes (All are concerning! - Homonymous hemianopsia: same side of both eyes, can be transient, lose pupillary reflexes - usu optic tract problem - Crossed hemianopsia: opposite sides, often pituitary problem - Quadrant hemianopsia: level of brain, pupil reflex present as optic tract not affected

Answer 19

Etiology: Aging, medications, (antihistamines/decongestants, post-eye sx, mal-positioned eyelids, dry climate, Vit A deficiency, chemical burn Keratoconjunctivitis siccs - bilateral dryness of eyes from lack of tears - redness, swelling, itching, burning and perhaps reduced vision (can be seen with RA, SLE or Sjogren's)

Answer 20

often from blunt trauma - “black eye” use ice, for 24 hrs, then alternate with heat. HP arnica, ledum, symphytum suture minor lacerations around eye area; refer if more extensive damage

Answer 21

``` Hemorrhage of conjunctival vessels - sclera gets very red; due to minor trauma- straining, sneeze or cough Not painful; no vision change, no pathological significance (unless blood dyscrasias), but alarming to pt. Conjunctival Injection (common) - peripheral, brick-red, tortuous superficial vessels; fade toward the iris; move with conjunctiva; blanch and refill with pressure (eg conjunctivitis) Ciliary Injection (less common) – (also known as ciliary flush or circumcorneal injection) violet or rose colored; fine, straight, deep vessels that radiate out from limbus (junction of conj. and cornea); fade toward periphery; doesn't blanch or move with conjunctiva. (eg iritis or acute glaucoma) ```

Answer 22

Etiology: allergic (common), viral, bacterial Predisposing factors: irritation from wind, dust, smoke, air pollution, common cold, corneal irritation from intense light/reflection from snow SSxs: conjunctival injection Unilateral suggests toxic, chemical, mechanical, or lacrimal origin). PE: normal intraocular pressure, PERRLA, normal vision Vision unchanged unless exudate clouds the eye

Answer 23

Recurs in spring and lasts through summer (with hay fever) SSxs: sudden, mild to moderate bilateral severe swelling of conjunctiva & lids conjunctiva appears pale but easily visible blood vessels not painful, but pruritus is extremely common clear, watery discharge is typical PE: preauricular adenopathy is absent Chemosis (thickened, boggy conjunctiva) is common Discharge amount is usually sparse; discharge quality is clear, thin, stringy Conjunctival injection is moderate Wright stain of discharge shows eosinophils

Answer 24

On/off throughout year Little evidence of inflammation but itching, burning and photophobia may be present Eyelid eversion may show velvety projections on palpebral conjunctiva May be misdiagnosed as dry eye syndrome

Answer 25

allergy to soft contact lenses; may be slow to develop Etiology: autoimmune response to pt’s own proteins or to the “trauma” of the lens wear SSxs: excessive pruritus, mucous production, increasing intolerance to contact use. PE: inflamed conjunctiva – red, itchy, and irritated may have a thick discharge, worse in morning eyelid eversion: see giant papillae usu on upper palpebral conjuctitva (cobblestone granulations)

Answer 26

adenovirus, common, lasts 1 – 2 wks SSxs: pruritus, minimal pain; clear, thin, watery discharge is typical. occasionally severe photophobia and foreign-body sensation occurs, usually caused by adenovirus when associated with keratitis (inflammation of cornea) (epidemic keratoconjunctivitis [EKC]) PE: pre-auricular adenopathy is common in EKC and herpes; chemosis is variable. discharge: amount—moderate or sparse; quality—thin, seropurulent conjunctival injection is moderate Concomitants: sore throat, nasal discharge (rhinitis)

Answer 27

affects only 1 eye, most often occurs on the cornea which results in herpes keratitis recurrences (in susceptible pts) usu take form of dendritic keratitis, with a characteristic raised lesion of the cornea “veins of a leaf”; nodules at terminal end of each “branch” SSxs: early: foreign body sensation, lacrimation, Photophobia, conjunctival injection late: anesthesia of cornea & dendritic keratitis lesion diagnostic ulceration and permanent scarring of cornea may result (loss of vision) Triggers fever, stress, sunlight, trauma associated with oral herpes, genital herpes immune compromised pts (HIV, DM) zoster (shingles) on the tip of the nose moving to cornea, resulting in uveitis and glaucoma

Answer 28

Etiology: Staph and Strep are most common pathogens (also N Gonorrhea and C trachomatis) SSxs: acute onset, minimal pain, occasional pruritus PE: preauricular adenopathy; chemosis is common. Discharge: copious; thick and purulent conjunctival injection is moderate to marked acute infx - gram stain or culture to identify chronic may produce little or no d/c except for crusting of eyelashes in AM, no itching

Answer 29

i) adult - rare, 12-48 hr incubation period - severe, purulent discharge, usu unilateral, lids swollen complications: corneal ulceration, abscess, blindness ii) neonate- purulent discharge, 2-5 days after birth, may be severe lid edema

Answer 30

i) adult inclusion conjunctivitis “swimming pool conjunctivitis”- from exposure to infected genital secretions other exposures from sharing eye make-up, etc tends to be chronic with exacerbation and remission pre-auricular adenopathy is occasional discharge: scant; seropurulent conjunctival injection is moderate ii) neonatal inclusion conjunctivitis (inclusion blennorrhea—exposure from cervix) 5-14 day incubation, sx may be mild to severe chemosis, mucopurulent d/c, often bilateral, no corneal damage occurs iii) Trachoma (Granular conjunctivitis) chronic infection of cornea and conj. caused by chlamydia Endemic in Africa, Asia, Middle East, Latin America, Pacific Islands, and aboriginal communities in Australia active disease most common in preschool children SSxs: Often asymptomatic - incubation of 7 days, most contagious in early stages usu. bilateral mucopurulent keratoconjunctivitis conj. congestion, eyelid edema, photophobia, lacrimation, pain; in 7 - 10 d follicles develop in upper lid, gradually forming yellow-gray granules may cause corneal ulceration PE: conjunctival surface of the upper eyelid shows a follicular/ inflammatory response cornea may have limbal follicles, superior neovascularization (pannus), and punctate keratitis. infection with C trachomatis concurrently occurs in nasopharynx

Answer 31

harmless slightly raised bumps, fatty deposits (yellow-white material) under conjunctiva (nasal side) No tendency to grow onto the cornea May become inflamed and red

Answer 32

conjunctival thickening from chronic inflammation from wind, dust often distinct triangular lesion which may grow over cornea & affect vision

Answer 33

Etiology: foreign body and/or abrasion SSxs: pain, photophobia, blepharospasm (spasm of lid, treated with botulism toxin to paralyze lid), may be blurred vision PE: evert lid to inspect for foreign body, Check cornea for foreign material or hemorrhage fluorescein stain picked up by blue lens Check PERRLA Ophthalmoscopic exam for retinal or vitreous hemorrhages or retinal detachment.

Answer 34

Etiology: HSV most common cause, contact lenses, traumatic corneal injury chronic topical steroid use varicella-zoster virus (VZV)—shingles in ophthalmic branch of trigeminal Nerve Bacterial infections - staphylococcal spp, P aeruginosa, Streptococcus pneumoniae, and Moraxella spp Hutchinson’s sign: The nasocilliary branch of CN V enervates tip of nose and cornea - leads to loss of corneal sensation, may lead to blindness SSxs: erythema of eyelid and conjunctiva, mucopurulent discharge, foreign body sensation, blurred vision, photophobia, pain

Answer 35

hard, white calcified plaques (bands) at 2, 5, 7, 10 o'clock of limbus may be hypercalcemia, secondary to kidney disease

Answer 36

whitish deposits around limbus; usu in elderly | may be related to hyperlipoproteinemia

Answer 37

Etiology: exposure to UV lights, welding arcs, "snow blindness" Radiation damage to the corneal epithelium is cumulative SSxs: onset of foreign-body sensation, irritation, pain, photophobia, tearing, blepharospasm, and decreased visual acuity 6-12 hours after the exposure. PE: diffuse staining with fluorescein dye (loss of epithelium) Lid edema, conjunctival hyperemia variable

Answer 38

Inflammation of uveal tract - (iris, ciliary body, choroids) most common in adults (age 20-50 yr) Classified as: i) anterior - iris (iritis), ciliary body (cyclitis), or both (iridocyclitis) ii) intermediate - (peripheral uveitis) iii) posterior - rare, serious condition (choroiditis, chorioretinitis) Etiology: often is associated with an underlying systemic disease, or may be idiopathic i) ankylosing spondylitis - more common in men pain, redness, photophobia in 1 or both eyes HLA-B27 +, SI involvement, rib cage involved ii) Reactive arthritis- (triad of arthritis, urethritis, conjunctivitis) - mainly men, HLA-B27 +, SI joint involved, prev STI or GI infection iii) infection- HSV, cytomegalovirus, VZV, toxoplasmosis, TB, histoplasmosis, syphilis iv) sarcoidosis—retina becomes inflamed, can lead to blindness v) auto-immune- collagen vasc. dz., juvenile rheumatoid arthritis (RA), Sjorgren's SSxs: Anterior - unilateral, painful ciliary flush, blurred vision, photophobia, and tearing Intermediate - painless; floaters and blurred vision Posterior uveitis: blurred vision, floaters, eye pain, photophobia PE: 360° peri-limbal injection, which increases in intensity as it approaches the limbus. visual acuity may be decreased in the affected eye.

Answer 39

opacity of the lens with painless, progressive, gradual visual loss. May see with a light or ophthalmoscope (positive diopters). Etiology: Developmental – “juvenile cataract” congenital or early life from poor diet, toxic inflammation or hereditary metabolic causes (important to check on child exams) Degenerative - senile degeneration, x-ray, UV light, trauma, diabetes; use of cortisone SSxs: decreased visual acuity is the most common complaint increased glare (bright sunlight or at night the glare of headlights) progression of cataracts leads to mild-to-moderate myopia No red reflex

Answer 40

(WILL have red eye) EMERGENCY Etiology: mechanical blockage of outflow channels in angle precipitating factors include drugs (ie, sympathomimetics, anticholinergics, antidepressants), and rapid correction of hyperglycemia. SSxs: patients are elderly, hyperopic, and have no history of glaucoma most commonly, present with peri-orbital pain and visual deficits; pain is “boring”, concomitant ipsilateral headache. blurry vision, describes seeing “halos around objects.” PE: blurred vision, can detect hand movements but can’t identify numbers or letters. corneal and scleral injection, ciliary flush. Edematous, cloudy cornea obscures fundoscopic exam. increased IOP (normal limit, 10-20 mm Hg) and ischemia: Pain on eye movement, Dilated non-reactive pupil Medial crescent shadow seen Ophthalmoscopic exam: increased cup/disc ratio DDx: conjunctivitis, acute iritis REFER immediately, eyesight may be lost permanently from increased pressure on optic nerve.

Answer 41

(NO red eye) - 90% of all glaucoma; caused by a malfunction of the eye’s drainage system, often from organic changes associated with aging. Etiology: decreased rate of aqueous outflow. Bilateral, genetic predisposition (autosomal recessive?) SSxs: gradual loss of peripheral vision. When uncontrolled, late loss of central vision and ultimate blindness Prevention: ocular tonometry every 3-5 years or with family hx yearly (10-21 mm Hg = normal) (abn. = 25-50 mm Hg., N pressure has diurnal variations of 3-4 mm Hg or more, so one normal does not R/O)

Answer 42

Hemorrhage into ant. chamber from trauma, see fluid line | Danger of recurrent bleeding which may cause glaucoma and visual loss

Answer 43

inflammation/infection of eyelid and surrounding skin anterior to the orbital septum (common in kids) Etiology: trauma, infection spread from nasal sinus or tooth, insect bite on face, seeding from bacteremia (S pneumoniae, S aureus, H flu), eyelid injury, conjunctivitis, chalazion SSxs: tenderness, swelling warmth, redness of eyelid. Visual acuity not affected Typically mild condition, rarely leads to complications Thus, Less of an emergency, but sometimes difficult to distinguish from

Answer 44

Emergency! infection of the orbital tissues (fat and muscles) posterior to the orbital septum. More common in kids Etiology: extension of infection from ethmoid sinus (~ 90% cases), local trauma, infx on face or teeth Same pathogens as above Progresses rapidly, can cause retinal artery or vein thrombosis, increased intraocular pressure - retinal damage, brain abscess, meningitis, cavernous sinus thrombosis SSxs: swelling and redness of eyelid and surrounding tissues, proptosis (down & lateral) extreme orbital pain (unilateral), and pain with eye movement, dec eye motility conjuctival hyperemia and chemosis decreased visual acuity depending on cause: nasal d/c, sinus bleeding, tooth abscess presence of fever, malaise, headache raise suspicion of meningitis (rash is late sign) DDX: other causes of eyelid swelling - allergy, insect bite, trauma, tumor REFER to ophthalmologist or EENT for hospitalization. CT, IV antibiotics, possibly drainage

Answer 45

bulging of eyes, also known as “proptosis” | Etiology: orbital inflammation, edema, injuries, hyperthyroid, leukemia, meningioma

Answer 46

Emergency! Etiology: trauma, diabetes, inflammatory disorder; posterior vitreous detachment (most common), may be idiopathic usually occurs aged 40-70 years. SSxs: painless, dark or irregular floaters, flashes of light (photopsia), blurred vision which worsens progressively, curtain or veil in the field of vision, no redness; tears or retinal pieces hanging in vitreous humor

Answer 47

With age, the vitrious gel can collapse and pull forward (may tear the retinal in the process) SSxs: painless, floaters, flashes of light

Answer 48

Leading cause of visual loss in the elderly (more common in whites than blacks) hemorrhagic disturbance in the macular region of the involved eye slow or sudden, painless loss of central visual acuity (wavy lines on Amsler grid) Ophthalmoscopic exam: drusen bodies

Answer 49

major cause of blindness in diabetics Early signs: venous dilation and small, red well demarcated lesions (microaneurisms), then macular edema develops which affects vision. Best seen with fluorescein angiography. Late signs: soft exudates (cotton-wool spots) (microinfarcts) caused by anoxia, or hard white-yellow (waxy) exudates caused by chronic edema from damaged capillaries Tortuous retinal neovascularization REFER if develop blurred vision (over 2 days) not assoc. with elevated glucose, sudden loss of vision in one or both eyes, black spots, cobwebs or flashing lights in the field of vision.

Answer 50

Vascular changes with extent and persistence of hypertension i) copper wire- brightening and widening of central strip on artery, moderate arteriosclerosis (yellow from lipids ) ii) silver wire- central light reflex is entire width of arteriole from thickened walls iii) AV nicking- arteriole crossing a venule, thickened arteriole walls compress and obscure the vein iv) hemorrhages (often flame hemorrhages) v) soft exudates-"cotton wool" (retinal edema)- fuzzy, gray-white, irregular border (infarcts vi) hard exudates (macular star) - well defined yellow-white deposits, may have serrated edges d/t deposits of serum, lipid and protein vii) Papilledema: optic disc swollen, margin blurred

Answer 51

Inherited, slowly progressive, bilateral, retinal degeneration with loss of photoreceptors and blindness Night blindness and peripheral vision loss may become symptomatic in early childhood Central island of vision gradually constricts over time

Answer 52

inflammation of lid margins causing irritation, itching, occasionally red eye Etiology: rosacea, seborrheic dermatitis, allergic or contact dermatitis, dry eye syndromes, chalazion, trichiasis, conjunctivitis, Sjogren’s syndrome, exposure to chemicals or irrantants SSxs: eye irritation (burning, gritty sensation, watering) itching and erythema of the lids, tearing, photophobia, blurred vision, crusting and matting of the lashes and medial canthus, esp in morning Typically a chronic course with intermittent exacerbations and eruptions PE: often findings of associated conditions loss of lashes (madarosis), whitening of the lashes (poliosis), scarring and misdirection of lashes (trichiasis), crusting of the lashes and meibomian orifices, eyelid margin ulcers, and lid irregularity (tylosis). corneal findings can include punctate epithelial erosions, marginal infiltrates, marginal ulcers.

Answer 53

external) "stye" Acute localized infection or inflammation of the eyelid margin involving sebaceous gland Staphylococcus aureus in 90-95% of cases, Common in kids SSxs: begins with pain, redness, tenderness of lid margin followed by small, round, tender induration, lacrimation, photophobia, foreign body sensation pustule on lid margin, ruptures and heals spontaneously. (internal) - rare Acute inflammation of meibomian gland, usu more severe pain, redness, edema more localized, abscess can form spontaneous rupture rare, recurrence is common

Answer 54

Chronic enlargement of meibomian gland from infection & occlusion of its duct, often following inflammation of the gland at onset, looks like a stye but painless; chronic stage may appear like BCC or SCC after few days, infection resolves leaving a painless, slowly growing, firm mass in the lid evert lid to see hyperemia and localized cyst

Answer 55

lid inversion lid area atrophic (elderly) or scarred, then lashes grow inward, causing irritation, blepharospasm, may lead to corneal ulceration and scarring

Answer 56

lid turns outward tissue relaxation with aging, edema Leads to poor drainage of tears, excess tearing, redness, irritation

Answer 57

enlarged lacrimal gland on upper lateral aspect of eye | tender, red if acute; painless if chronic. Can abscess

Answer 58

inflammation of lacrimal sac (seen in infants) usu secondary to obstruction of nasolacrimal duct tenderness, swelling, redness; may express pus from sac

Answer 59

congenital narrowed lacrimal duct in neonate | Excess tearing, may be pus expressed, usu resolves in 6 mos

Ears/Eyes Flashcards

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