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CLO > Lacrimal Gland & Tear Film Pathologies > Flashcards

Lacrimal Gland & Tear Film Pathologies Flashcards

(45 cards)

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1
Q

Dacryocystis: Aetiology

A

Inflammation of lacrimla sac

Can be acute or chronic

Cause by infections, blockages or poor patency of nasolacrimal duct (injury/infection/congenital abnormality)

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2
Q

Dacryocystis: Predisposing Factors

A

Congenital nasolacrimal duct blockage

Female

Trauma or surgery

Sinusitis

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3
Q

Dacryocystis: Signs

A

Swelling around lacrimal duct (inferior nasal)

Red

Discharge from puncta mucopurulent

Can present with preseptal cellulitis and conjunctivitis

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4
Q

Dacryocystis: Symptoms

A

Tneder/painful

Epiphora

Fever

Acute onset

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5
Q

Dacryocystis: Differential Diagnosis

A

Cellulitis - if limits eye movement or redness not limited to lacrimal sac area

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6
Q

Dacryocystis: Management by CLO

A

Cease CL wear

Refer

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7
Q

Dacryocystis: Referral

A

Emergency

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8
Q

Dacryoadenitis: Aetiology

A

Inflammation of lacrimal gland

Can be caused by viral or bacterial infection or systemic inflammatory conditions

Usually self limiting

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9
Q

Dacryoadenitis: Predisposing Factors

A

Uncommon

Male/female equal

No common age

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10
Q

Dacryoadenitis: Signs

A

Swelling around lacrimal gland (superior temporal)

Red

Watery and puss discharge

Ptosis of lid due to swelling

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11
Q

Dacryoadenitis: Symptoms

A

Tender/painful

Excessive tearing with discharge

Acute or chronic depending on cause

Fever

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12
Q

Dacryoadenitis: Differential Diagnosis

A

Cellulitis

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13
Q

Dacryoadenitis: Management by CLO

A

Cease CL wear

Monitored for self resolution (adults)

Chronic should be referred for investigation of cause

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14
Q

Dacryoadenitis: Referral

A

Emergency for children

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15
Q

Ectropian: Aetiology

A

Lower lid turns out with loss of tone

Especially at nasal corner with poor location of puncta for drainage

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16
Q

Ectropian: Predisposing Factors

A

Age - 60+

Trauma

Tumours

Surgery

Palsy

Congenital

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17
Q

Ectropian: Signs

A

Red adnexa from epiphora

Dry eye symtoms

Watery eyes

Exposure keratitis inferior

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18
Q

Ectropian: Symptoms

A

Continual epiphora - continuously wiping tears

Soreness of cheek from epiphora

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19
Q

Ectropian: Management by CLO

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A

Advise to wipe upwards

Bandage CL where corneal exposure risks keratitis

20
Q

Ectropian: Referral

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A

Routine for surgery with keratitis and chronic epiphora

21
Q

Ectropian: Contact Lens implications

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A

Dry eye due to poor tear movement

High risk for conjunctivitis

High risk of keratitis

Daily lenses with low water content or SiHy bandage lens

22
Q

Lid Notching (MGD): Aetiology

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A

Lower lid notching due to atrophy of meibomian glands

Irreversible

Gland puckered inwards

23
Q

Lid Notching (MGD): Predisposing Factors

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A

Chronic posterior blepharitis

24
Q

Lid Notching (MGD): Signs

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A

Irregular lid margin

Notched areas with poor contact on globe

Epiphora

Dry eye along side MGD

Poor tear flow

25
Lid Notching (MGD): Symptoms
Epiphora Dry eye symptoms
26
Lid Notching (MGD): Management by CLO
Treatment of MGD/blepharitis Use of lubricants Hot compresses
27
Lid Notching (MGD): Referral
None
28
Lid Notching (MGD): Contact Lens Implications
Cry eye due to poor tear movement/drainage Limitations on wear time (poor tears/evaporation)
29
Evaporative Dry Eye: Aetiology
Multifactorial disease Likely cause by poor patency or pathology of meibomian glands Hyperosmolarity caused which destabilises tears and causes inflammation
30
Evaporative Dry Eye: Predisposing Factors
Environmental factors VDU use Refractive surgery CL wear Age Menopause
31
Evaporative Dry Eye: Signs
Congealed meibomian gland orifices Creamy discharge Hardened lumps on gland orifices Lid notching
32
Evaporative Dry Eye: Symptoms
Dry eye symptoms Lens intolerance Watery eyes in windy conditions
33
Evaporative Dry Eye: Grading
Use Efron to grade MGD Measuring osmolarity is best for monitoring Can grade bulbar conjunctival redness & staining caused by dry eye
34
Evaporative Dry Eye: Differential Diagnosis
Conjunctivitis Incomplete blink reflex/incomplete lid closure at night Associated blepharitis Aqueous deficient dry eye
35
Evaporative Dry Eye: Management by CLO
Treatment for chronic MGD/blepharitis Advise lubricants Hot compresses Education on environment/VDU breaks Increase omega 3 and water intake
36
Evaporative Dry Eye: Referral
Routine - can receive antibiotics for chronic MGD
37
Evaporative Dry Eye: Contact lens implications
CL intolerence Limit on wear due to poor tears and increased evaporation Increased risk of infection
38
Aqueous Deficient Dry Eye: Aetiology
Multifactorial disease based on reduced tear quantity
39
Aqueous Deficient Dry Eye: Predisposing Factors
Systemic inflammatory challenges Innervation of lacrimal gland problems Sjogren's disease sufferer Dehydration
40
Aqueous Deficient Dry Eye: Signs
Reduced tear meniscus Minimal tear coverage Poor take up of fluorescein Mucal strands on cornea Blurred vision
41
Aqueous Deficient Dry Eye: Symptoms
Severe dry eye symptoms Blurred vision
42
Aqueous Deficient Dry Eye: Differential Diagnosis
Conjunctivitis Incomplete blink reflex Associated blepharitis Evaporative dry eye
43
Aqueous Deficient Dry Eye: Management in practice
Artificial tears Bandage contact lens
44
Aqueous Deficient Dry Eye: Referral
Routine - treatment of underlying systemic concerns - permanent occulsion of puncta - autologous serum drops
45
Aqueous Deficient Dry Eye: Contact Lens Implications
Likely unsuitable for contact lenses until treated Low water content lenses Bandage lenses

CLO (13 decks)

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