Eyelid disorders Flashcards
(8 cards)
Describe what causes blepharitis [2] and how it is treated [1]
Blepharitis refers to inflammation of the eyelid margins.
It causes a gritty, itchy, dry sensation in the eyes. It can be associated with dysfunction of the Meibomian glands, which are responsible for secreting meibum (oil) onto the surface of the eye. It can lead to styes and chalazions.
Describe the clinical features of blepharitis [+]
symptoms are usually bilateral
grittiness and discomfort, particularly around the eyelid margins
eyes may be sticky in the morning
eyelid margins may be red. Swollen eyelids may be seen in staphylococcal blepharitis
styes and chalazions are more common in patients with blepharitis
secondary conjunctivitis may occur
Mx of blepharitis? [3]
softening of the lid margin using hot compresses twice a day
‘lid hygiene’ - mechanical removal of the debris from lid margins
- cotton wool buds dipped in a mixture of cooled boiled water and baby shampoo is often used
artificial tears may be given for symptom relief in people with dry eyes or an abnormal tear film
What is a stye [1]
How is it treated? [2]
Infection of the glands (glands of Zeis or glands of Moll) of the eyelids, at the base of the eyelashes
Mx:
* Styes are treated with hot compresses and analgesia.
* Topical antibiotics (e.g., chloramphenicol) may be considered if it is associated with conjunctivitis or if symptoms are persistent.
Hordeolum externum is an infection of the glands of Zeis or glands of Moll.
What is a chalazion? [1]
Tx? [2]
A chalazion occurs when a Meibomian gland becomes blocked and swells. It is often called a Meibomian cyst. It presents with a swelling in the eyelid that is typically not tender (however, it can be tender and red).
Tx:
Treatment is with warm compresses and gentle massage towards the eyelashes (to encourage drainage). Rarely, surgical drainage may be required.
What is the difference betwen an entropion and an ectropion? [2]
What can they lead to? [2]
Entropion refers to when the eyelid turns inwards with the lashes pressed against the eye.
- This causes pain and can result in corneal damage and ulceration.
Ectropion refers to when the eyelid turns outwards, exposing the inner aspect.
- It usually affects the bottom lid. This can result in exposure keratopathy, as the eyeball is exposed and not adequately lubricated and protected.
Tx for entropion or ectropion? [2]
Entropion:
- Initial management is by taping the eyelid down to prevent it from turning inwards - when the eyelid is taped down, it is essential to prevent the eye from drying out by using **regular lubricating eye drops. **
- Definitive management is surgical
Ectropion:
* Mild cases may not require treatment.
* Regular lubricating eye drops are used to protect the surface of the eye. More significant cases may require surgery to correct the defect
What is trichiasis? [1]
Mx? [1]
Trichiasis refers to inward growth of the eyelashes. It results in pain and can cause corneal damage and ulceration.
Management involves removing the affected eyelashes. Recurrent cases may require electrolysis, cryotherapy or laser treatment to prevent them from regrowing. A same-day referral to ophthalmology is required if there is a risk to sight.
