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HEENT Clin Med > Eyelid disorders > Flashcards

Eyelid disorders Flashcards

1
Q

Where are the meibomian glands found

A

embedded in connective tissue of tarsi plates

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2
Q

What lines the posterior eyelid

A

palpebral conjunctiva composed of epithelium and sub epithelial stroma

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3
Q

Where are goblet cells contained in the eyelid

A

epithelium of tarsi

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4
Q

What is a Hordeolum

A

Stye

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5
Q

What is the clinical presentation of a chalazion

A

Initial diffuse swelling of eyelid
-1-2 days will localize to eyelid body
-drains through inner eyelid surface
-spontaneously absorbs in 2-8 weeks

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6
Q

What causes hordeolum

A

Infectious, painful localized swelling to the eyelid margin

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7
Q

What is a chalazion

A

Non-infectious obstruction of the meibomian gland causing irritation of lipid material in eyelid and soft tissue

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8
Q

What are some risk factors for chalazions

A

Meibomian gland disfunction
acne
rosacea

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9
Q

What side effect outside of eyelid swelling can a chalazion cause

A

indentation of the cornea causing blurred vision

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10
Q

What type of infection causes hordeolum

A

Pyogenic staph infection

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11
Q

Where are hordeolum found on the eye

A

external from obstruction/infection of eyelash follicle and adjacent gland (Zeis and moll glands)

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12
Q

What is the clinical presentation of an external hordeolum

A

1-2 days of tearing, photophobia, foreign body sensation
-small yellow pustule surrounded by hyperemia
-w/n 2-4 days lesion will rupture

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13
Q

When is an internal hordeolum suspected

A

severe inflammation
fever
chills

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14
Q

When do chalazion require bx and why

A

When they are chronic and dont respond to treatment

need to exclude tumor of eyelid

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15
Q

When is treatment required for chalazion and what is it

A

Incision & curettage / intra-chalazion corticosteroid therapy w/ triamcinolone

when large, unsightly and going on for several weeks despite conservative tx

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16
Q

When is treatment required for external hordeolum and what is it

A

When not responding to hot compress

incise with sharp and give doxy or erythromycin when cellulitis present

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17
Q

What is the treatment for internal hordeolum

A

oral abx and I&D

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18
Q

What is blepharitis

A

inflammation of eyelid margin
*can be acute or chronic

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19
Q

What are the s/sx of blepharitis

A

itching and burning of eyelid margin with redness and edema

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20
Q

How do you treat acute ulcerative blepharitis

A

topical antibiotics
or
systemic antivirals

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21
Q

How is acute non-ulcerative blepharitis treated

A

occasionally with topical corticosteroid

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22
Q

How is chronic blepharitis treated

A

tear supplements
warm compress

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23
Q

What is the cause of acute blepharitis

A

generally a staph infection at origin of eyelashes

*could have viral source (HSV, VZV)

24
Q

How can you tell the difference between bacterial and viral blepharitis

A

bacterial generally has more crusting than viral

25
Q

What is the cause of acute non-ulcerative blepharitis

A

allergic reaction

26
Q

How is blepharitis generally worked up/ diagnosed

A

slit lamp exam

27
Q

How do you treat acute ulcerative blepharitis

A

abx ointment
-bacitracin/polymyxin B, erythromycin, gentamicin 7-10 days

28
Q

How do you treat acute viral ulcerative blepharitis

A

Acyclovir for 7 days

29
Q

How do you treat acute non-ulcerative blepharitis

A

avoid offending action/substance
warm compress

if swelling persists >24hrs ophthalmic ointment for 7 days

30
Q

how do you treat seborrheic blepharitis

A

cleansing of eyelid margin with dilute baby shampoo

31
Q

What is inversion of the eyelid

A

Entropin

32
Q

What is eversion of lower eyelid

A

ectropion

33
Q

What causes entropion

A

Age related tissue relaxation

34
Q

What is a definitive treatment of entropion

A

surgery

35
Q

What are the symptoms of entropion

A

foreign body sensation
tearing
red eye

36
Q

What causes ectropion

A

age related tissue relaxation
posttraumatic
CN VII palsy

37
Q

What are the symptoms of ectropion

A

tearing
dry eye sx

38
Q

How do you treat ectropion

A

Surgery = definitive
tear supplements
ocular lubricants at night

39
Q

What is dacrocystitis

A

infection of lacrimal sac that may cause abscess formation

40
Q

What is the cause of dacrocystitis

A

Staph or strep in nasolacrimal duct

41
Q

How do you diagnose dacrocystitis

A

when pressure is placed on the lesion, mucoid material will leak through puncta

42
Q

How do you treat dacrocystitis

A

Mild = warm compress
severe = 1st gen cephalosporin IV

43
Q

How do you treat chronic dacrocystitis

A

surgery

44
Q

What is the most common malignant eyelid tumor

A

basal cell carcinoma in caucasians

Sebaceous gland carcinoma in asians

45
Q

What is the most common benign epithelial tumor

A

squamous papilloma

46
Q

What are benign epithelial eyelid tumors

A

keratocanthoma
seborrheic keratosis
cutaneous horn
squamous papilloma

47
Q

What is the most precancerous lesion on the eyelid

A

actinic keratosis (turn into SCC)

48
Q

What are benign melanocytic eyelid tumors

A

freckles
lentigo simplex
solar lentigo
eyelid nevi

49
Q

Who is at risk for developing cutaneous melanoma of eyelid

A

fair skinned adults
history of UV radiation

50
Q

What are cystic eyelid tumors

A

epidermal inclusion
sweat gland tumor
hair follicle tumor
stromal tumor
xanthelasma

51
Q

What is the main difference with BCC and SCC

A

BCC is generally found inner and lower eyelid

SCC is generally upper and outer eyelid

52
Q

What is xanthelasma

A

Common benign deposit of yellow-white flat plaques of lipid material SQ of upper and lower lid

53
Q

Which population are xanthelasma most common

A

middle age- elderly

54
Q

What are vascular tumor of the eyelid

A

capillary hemangioma
nevus flameus
kaposi’s sarcoma

55
Q

Which eyelid tumor can be described as a port wine stain

A

nevus flameus

56
Q

What is the most common vascular tumor of the eyelid

A

capillary hemangioma

57
Q

What is a neurogenic eyelid tumor

A

solitary neurofibroma (may resemble chalazion)

HEENT Clin Med (7 decks)

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