Eyelid Disorders

Question 1

What is blepharitis?

Answer 1

Inflammation of the eyelid margins

Question 2

What can blepharitis lead to?

Answer 2

Chalzions and styes

Question 3

Presentation of blepharitis?

Answer 3

Gritty, itchy, dry sensation in eyes

Question 4

What can blepharitis be associated with?

Answer 4

Dysfunction of Meibomian glands

Question 5

What are Meibomian glands?

Answer 5

Responsible for secreting oil onto eye surface

Question 6

Management of blepharitis?

Answer 6

Hot compress

Gentle cleaning of the eyelid margins to remove debris using cotton wool dipped in sterilised water & baby shampoo

Question 7

What can be used for symptomatic relief in Blepharitis?

Answer 7

Lubricating eye drops

Question 8

Different types of eye drops for lubrication?

Answer 8

Hypromellose drops (Least viscous)
Polyvinyl alcohol drops 
Carbomer drops (last 30-60 mins, most viscous)

Question 9

2 types of stye?

Answer 9

Hordeolum externum:

Hordeollum internum

Question 10

What is hordeolum externum?

Answer 10

Infection of the glands of Zeus or glands of Moll

Question 11

Presentation of hordeolum externum?

Answer 11

Tender red lump along eyelid + possible pus

Question 12

What and where are the glands of Zeis?

Answer 12

Sebaceous glands @ base of eyelash

Question 13

What and where are the glands of Moll?

Answer 13

Sweat glands at base of eyelashes

Question 14

What is hordeolum internum?

Answer 14

Infection of Meibomian glands?

Question 15

Presentation of hordeolum internum?

Answer 15

Deeper, more painful and may point inwards toward eyeball, underneath eyelid

Question 16

Management of styes?

Answer 16

Hot compress and analgesia

Consider topic antibiotics eg chloramphenicol if associated with conjunctivitis or symptoms are persistent

Question 17

What is a chalzion?

Answer 17

Often called a Meibomian cyst

Question 18

Why does a chalzion occur?

Answer 18

When a Meibomian gland becomes blocked & swells

Question 19

Presentation of a chalzion?

Answer 19

Swelling in eyelid, typically not tender however can sometimes be tender & red

Question 20

Management of a chalzion?

Answer 20

Hot compress & analgesia

• Consider topic antibiotics (chloramphenicol) if inflammed acutely
• Rarely if other management fails consider surgical drainage

Question 21

What is an entopion?

Answer 21

Condition where the eyelid turns inwards with the lashes against the eyeball

Question 22

Presentation of entropion?

Answer 22

Pain and can result in corneal damage & ulceration

Question 23

Initial management of entropion?

Answer 23

Taping eyelid down to prevent it turning upwards

prevent the eye drying with lubricating drops

Question 24

Definitive management for entropion?

Answer 24

Surgical intervention

Question 25

What is ectropion?

Answer 25

Where the eyelid turns outwards with inner aspect of the eyelid exposed This usually affects the bottom lid

Question 26

What can ectropion result in?

Answer 26

Exposure keratopathy as the eyeball is exposed & inadequately lubricated/protected

Question 27

Treatment of moderate ectropion?

Answer 27

Regular lubricating eye drops

Question 28

Treatment of mild ectropion?

Answer 28

None required

Question 29

Treatment of severe ectropion?

Answer 29

Significant cases require surgery to connect

Question 30

What is trichiasis?

Answer 30

Inward growth of eyelashes

Question 31

Presentation of trichiasis?

Answer 31

Pain and corneal damage/ulceration

Question 32

Management of trichiasis?

Answer 32

``` Specialist removes eyelash (epilation) Recurrent cases get -Electrolysis -Cryotherapy -Laser treatment All to prevent eyelash regrowth ```

Question 33

What is periorbital cellulitis?

Answer 33

Eyelid & skin infection infront of the orbital septum (the eye)

Question 34

What is periorbital cellulitis AKA?

Answer 34

Preorbital

Question 35

Presentation of preorbital cellulitis?

Answer 35

Swelling Redness Hot skin around eye

Question 36

Which is sight threatening orbital cellulitis or preorbital cellulitis?

Answer 36

ORBITAL

Question 37

Which investigation helps differentiate between preorbital and orbital cellulitis?

Answer 37

CT scan

Question 38

Treatment of preorbital cellulitis?

Answer 38

``` Systemic antibiotics (oral or IV) Preorbital can develop into orbital in vulnerable patient such as children so may require admission to be observed ```

Question 39

What is orbital cellulitis?

Answer 39

Infection around the eyeball involving tissues behind the orbital septum

Question 40

Presentation of orbital cellulitis?

Answer 40

``` Pain on eye movement Changes in vision Reduced eye movements Abnormal pupil reaction Forward movement of eyeball (proptosis) ```

Question 41

Management of orbital cellulitis?

Answer 41

MEDICAL EMERGENCY Admit patient IV antibiotics May require surgical drainage if an abscess forms