Lids/ Lashes Flashcards
(195 cards)
1
Q
RTC for phthiriasis palpebrarum?
A
1 day
Because eggs may be hard to see and missed, eggs hatch daily, therefore need to monitor daily to ensure complete removal of eggs and lice
2
Q
Tx of angioedema
A
Oral antihistamine and cold compress 4-6x/ day
3
Q
RTC for angioedema
A
2-3 days to ensure resolution
4
Q
Symmetrical bilateral ptosis onset around 20 years old is seen in which condition?
A
CPEO
Chronic progressive external ophthalmoplegia
5
Q
Chloasma
A
Increased pigmentation around eyes and cheeks in pregnant women
*”mask of pregnancy”
6
Q
What is Epiblepharon?
A
A congenital condition characterized by the absence of a lower lid crease, causing eyelashes to be oriented vertically.
Commonly observed in individuals of Asian descent and those with a high body mass index.
7
Q
What are potential causes for Epiblepharon?
A
It may occur secondarily to:
* Surgical procedure
* Trauma
* Graves’ disease (leads to hyperthyroidism)
It can also be congenital.
8
Q
What symptoms are associated with Epiblepharon?
A
- Foreign body sensation
- Ocular irritation
- Reflexive tearing
- Patients may be asymptomatic
Symptoms can vary in severity.
9
Q
What are the clinical signs of Epiblepharon?
A
- Vertical misdirection of lashes towards the globe
- Mild corneal scratches
- Superficial punctate keratitis (SPK)
- Associated scarring of the cornea
The upper eyelid is rarely involved.
10
Q
At what age may Epiblepharon spontaneously resolve in children?
A
By the age of 6 to 7 years
This resolution is secondary to facial elongation.
11
Q
True or False: Epiblepharon can lead to decreased vision.
A
True
Decreased vision is exacerbated by down gaze due to corneal irritation.
(Absence of lower lid crease, causing eyelashes to be oriented vertically)
12
Q
Fill in the blank: Epiblepharon is characterized by the absence of a _______.
A
lower lid crease
This absence causes the eyelashes to misdirect vertically.
13
Q
What are some treatment options for Epiblepharon?
A
- Rotating the lid margin and taping it away from the globe
- Application of a soft contact lens to protect the cornea
- Epilation of the offending lashes (if there is only a small number)
- Full-thickness suturing of the eyelid to create a normal eyelid crease (oculoplastics)
These options vary based on the severity and specific circumstances of the condition.
14
Q
What should be prescribed in the presence of superficial punctate keratitis (SPK)?
A
Prescription of an age-appropriate topical antibiotic to ensure corneal health
This is important to prevent further complications associated with corneal involvement.
15
Q
When is surgery warranted for Epiblepharon?
A
If there is a significant degree of corneal involvement
Surgical intervention may be necessary to prevent further damage to the cornea.
16
Q
Under what condition does epiblepharon not require urgent attention?
A
If the cornea is clear and there is no potential for lash misdirection onto the corneal surface
In such cases, patients may simply be monitored intermittently.
17
Q
What is the primary approach to managing Epiblepharon if there is no corneal involvement?
A
The patient may simply be monitored intermittently to safeguard against future corneal involvement
This approach focuses on observation rather than immediate intervention.
18
Q
What causes phthiriasis?
A
Phthiriasis is caused by pubic lice, also known as crab lice.
The scientific name for the organism is Phthirus pubis.
19
Q
What is the size and body structure of Phthirus pubis?
A
Phthirus pubis measures roughly 2 mm in length and possesses a broad, flat body.
This small organism is specifically adapted to live in pubic hair.
20
Q
How does pediculosis differ from phthiriasis?
A
Pediculosis is caused by a different form of louse that has greater mobility and is typically found on the scalp, while phthiriasis is caused by P. pubis, which is slow-moving and rarely found on the scalp.
Pediculosis is more easily transmitted between individuals.
21
Q
Transmission of phthiriasis via?
A
close contact between individuals.
This is often associated with overcrowding or inferior hygiene.
22
Q
What are common symptoms of phthiriasis?
A
Patients may report ocular itching and potentially conjunctival injection.
These symptoms are indicative of an infestation affecting the eye area.
23
Q
What clinical signs may be observed during a slit lamp exam for phthiriasis? (Name at least 4)
A
Clinical signs may include:
* Lice clinging to the base of the eyelashes
* Small brown deposits on the lid margin (feces)
* Dried blood along the base of the eyelashes
* Small circular translucent nits (eggs)
* Conjunctival injection and follicles
* Potential preauricular lymphadenopathy
* Marginal keratitis in extreme cases
* Dermal blue spots (maculae caeruleae) from lice saliva
These signs help in diagnosing phthiriasis.
24
Q
What is the first step in the treatment of phthiriasis?
A
Mechanical removal of all nits and lice with jeweler’s forceps.
The lice should be placed onto an alcohol wipe for immediate disposal.
25
What topical treatments may be beneficial after lice removal?
A bland ophthalmic ointment such as bacitracin or erythromycin applied tid for 10 days after removal is beneficial.
## Footnote
This helps in managing any residual infection or irritation.
26
What is a potential prescription option for phthiriasis treatment?
1% mercuric oxide qid for 14 days may be prescribed.
## Footnote
However, patient compliance can affect the treatment's effectiveness.
27
What side effects are associated with mercuric ointment?
Ocular irritation, lens discoloration, and other side effects.
## Footnote
These can discourage patients from using the treatment as directed.
28
What alternative treatment involves physostigmine?
Two applications of 0.25% physostigmine applied 7 days apart may be prescribed.
## Footnote
This medication is also associated with ocular side effects.
29
Are anti-lice shampoos approved for ocular use?
No, anti-lice shampoos are not approved for ocular use.
## Footnote
Patients should wash their hair with anti-lice shampoo but avoid applying it to the eyes.
30
What additional hygiene measures should patients take if they have phthiriasis?
Patients should wash all bedding and towels that they may have used and consider cutting the lashes to the base to remove possible lice adhesion sites.
## Footnote
This helps prevent re-infestation.
31
What follow-up care is recommended for patients with phthiriasis?
Patients should be monitored every day because the eggs may be difficult to observe and any missed nits will hatch daily.
## Footnote
Regular follow-up is crucial for effective treatment.
32
What must be evaluated in a child diagnosed with phthiriasis?
A child diagnosed with phthiriasis must be evaluated for possible sexual abuse.
## Footnote
This is due to the nature of transmission and potential risk factors.
33
What is Meibomian gland dysfunction (MGD)?
A condition resulting from dysfunctional sebaceous glands
## Footnote
Also known as posterior blepharitis.
34
What conditions commonly occur alongside Meibomian gland dysfunction?
Anterior blepharitis and seborrheic dermatitis
## Footnote
These conditions can exacerbate MGD.
35
Which bacteria are believed to aggravate Meibomian gland dysfunction?
S. aureus and S. epidermidis
## Footnote
These are gram-positive bacteria that release lipases affecting lipid production.
36
What is the effect of lipases released by bacteria on the ocular surface?
They hydrolyze lipids, producing free fatty acids that irritate the ocular surface
## Footnote
This leads to dry eye symptoms.
37
List some common symptoms of Meibomian gland dysfunction.
* Stinging
* Dryness
* Itching
* Excessive tearing
* Burning
* Photophobia
* Foreign body sensation
* Decreased visual acuity
38
What clinical signs may be observed in a patient with Meibomian gland dysfunction?
* Excessively oily and frothy tear film
* Inspissated secretions
39
What are some long-term complications of Meibomian gland dysfunction?
* Chalazion
* Trichiasis
* Madarosis (missing lashes)
* Thickening and notching of eyelid margins
* Telangiectasia
40
What are the primary treatments for Meibomian gland dysfunction?
* Warm compresses
* Eyelid massage
* Eyelid scrubs
* Antibiotic ointments
* Transient topical steroid use
41
How often should warm compresses and massage be performed initially for MGD?
Twice a day
## Footnote
This should continue until the condition stabilizes.
42
When might oral antibiotics be required in the treatment of Meibomian gland dysfunction?
When MGD is unresponsive to other treatments, severe, or if there is poor compliance
43
Fill in the blank: The tear film in Meibomian gland dysfunction may appear excessively _______.
[oily and frothy]
44
What is Meibomian Gland Dysfunction (MGD)?
A disorder affecting the meibomian glands, leading to dry eye symptoms.
45
What is the first step in treating anterior blepharitis?
Complete lid scrubs to remove bacteria.
46
What is the recommended treatment order for posterior blepharitis?
Warm compress, lid massage, then lid scrubs
47
What advanced treatments may be required for severe cases of MGD?
In-office gland expression using technologies like LipiFlow® or iLux®.
48
What types of topical ointments may be prescribed for MGD?
Bacitracin, tetracycline, or erythromycin.
49
What is AzaSite® and why is it beneficial?
A topical azithromycin that is lipophilic and gel-forming, providing longer ocular retention.
50
What is the typical dosage for tetracycline in MGD treatment?
250 mg q.i.d.
51
What is the modified dosage for doxycycline that maintains efficacy?
20-50 mg.
52
What is included in the Alodox® Convenience Kit?
* Low dose doxycycline (20 mg)
* OcuSoft® lid hygiene pads
* Tranquileyes® moist heat therapy goggles
53
What OTC supplement is suggested to improve dry eye associated with MGD?
Omega-3 fatty acids at a dosage of 2-3 g per day.
54
How has Restasis® proven beneficial for MGD patients?
It reduces lid margin inflammation in patients with MGD and/or rosacea.
55
True or False: The usage of Restasis® for MGD is considered on-label.
False.
56
RTC for MGD dx
3-4 weeks
* pt should be educated about how MGD is chronic, likely will need to continue eyelid scrubs and massage indefinitely
57
Adverse side effects of Kenalog eyelid injection (tx resistant chalazia and expedite resolution)
- de pigmentation at injection spot
- elevated IOP
- retinal and/or choroidal vascular occlusion
- pain on injection
- temporary skin atrophy
58
Which conditions can cause a false appearance of a ptosis?
- contralateral eyelid retraction (proptosis)
- ipsilateral hypotropia
- brow ptosis
- dermatochilasis
- lack of lid support by the globe
- blepharospasm
- Duane syndrome
59
What ocular condition may cause a false appearance of ptosis?
Contralateral eyelid retraction
## Footnote
Other conditions include proptosis, ipsilateral hypotropia, brow ptosis, dermatochalasis, enophthalmos, phthisis bulbi, blepharospasm, and Duane syndrome.
60
How does ipsilateral hypotropia contribute to pseudoptosis?
The upper eyelid naturally follows the globe downward
## Footnote
The appearance of pseudoptosis disappears when the fellow eye is covered.
61
What measurements are important for evaluating suspected ptosis?
Marginal-reflex distance (MRD), palpebral fissure height, positioning of the upper and lower eyelids
## Footnote
MRD should be 4-4.5 mm, palpebral fissure height should be 7-10 mm in males and 8-12 mm in females.
62
What is the normal positioning of the upper and lower eyelids?
Upper lids about 2 mm below the superior limbus, lower lids approximately 1 mm above the inferior limbus.
63
What is Marcus Gunn jaw-winking syndrome characterized by?
An abnormally positioned upper eyelid considered a true ptosis
## Footnote
The ptosis improves by stimulating the ipsilateral pterygoid muscles via chewing, sucking, or opening the mouth.
64
What is Blepharophimosis syndrome?
A rare autosomal dominant condition with moderate to severe symmetrical ptosis, short horizontal palpebral aperture, telecanthus, and epicanthus inversus
## Footnote
Other features include lateral ectropion of lower lids and poorly developed nasal bridge with hypoplasia of the superior orbital rims.
65
What condition is associated with variable true ptosis that increases with fatigue?
Myasthenia gravis
66
What is the proper technique for evaluating the levator muscle?
Firmly place your thumb against the patient's brow, ask the patient to look down, zero the ruler at the upper lid margin, then ask the patient to look up and measure the upper eyelid margin on the ruler.
67
What characterizes good levator function?
12 mm or more
68
What characterizes fair levator function?
5-11 mm of upper eyelid excursion
69
What characterizes poor levator function?
4 mm or less
70
What is the main function of the orbicularis oculi muscle?
To close the eyelids
71
What is the common name for the corrugator supercilii muscle?
Frowning muscle
72
What is the action of the corrugator supercilii muscle?
Draws the eyebrows downward and medially
73
What is the main action of the procerus muscle?
Depression of the skin between the eyebrows
74
What does the orbicularis oris muscle do?
Closes the mouth and puckers the lips
75
Fill in the blank: The main function of the orbicularis oculi muscle is to _______.
close the eyelids
76
How is the upper eyelid crease measured?
As the vertical distance between the upper eyelid margin on downgaze and the upper eyelid crease
77
What is the typical measurement of the upper eyelid crease in females?
10 mm
78
What is the typical measurement of the upper eyelid crease in males?
8 mm
79
What does the absence of the eyelid crease suggest?
Congenital ptosis with poor levator function
80
What is commonly observed in patients with a high eyelid crease?
An aponeurotic defect
81
Fill in the blank: The eyelid crease is typically larger in _______.
females
82
True or False: The upper eyelid crease measurement is the same for males and females.
False
83
What is eyelid ptosis?
An abnormally low positioning of the upper eyelid that may be congenital or acquired
84
What are the four anatomical classifications of eyelid ptosis?
* Myogenic
* Neurogenic
* Aponeurotic
* Mechanical
85
What characterizes myogenic ptosis?
Decreased levator function due to myopathy or impaired nerve impulse transmission
86
What causes simple congenital ptosis?
Failure of neuronal migration and development during fetal growth
87
What conditions can lead to acquired myogenic ptosis?
* Myasthenia gravis
* Myotonic dystrophy
* Chronic progressive external ophthalmoplegia
88
What is a classic sign of myogenic ptosis?
(Weak levator)
A weak or absent eyelid crease
89
What is neurogenic ptosis caused by?
An innervational defect to the levator muscle
90
Which cranial nerve palsy is most commonly associated with neurogenic ptosis?
Third cranial nerve palsy
91
What is Horner syndrome?
Oculosympathetic palsy that presents with subtle upper and lower eyelid ptosis
92
What is a characteristic of Marcus Gunn jaw-winking syndrome?
A ptotic eyelid elevates with jaw movement
93
What causes aponeurotic ptosis?
A defect in the levator aponeurosis due to dehiscence, dis-insertion, or stretching
94
What are common signs of aponeurotic ptosis?
* High eyelid crease
* Good levator function
* Moderate degree of ptosis (3 to 4mm)
95
What is mechanical ptosis?
Ptosis caused by a gravitational effect of an eyelid mass or eyelid scarring
96
What potential causes can lead to mechanical ptosis?
* Retained contact lenses
* Eyelid inflammation (chalazion)
* Giant papillary conjunctivitis
* Neoplasm/tumor
97
What is traumatic ptosis?
Ptosis resulting from eyelid laceration, contusion injury, or orbital roof fracture
98
Fill in the blank: Myogenic ptosis can be _______ or acquired.
congenital
99
True or False: Aponeurotic ptosis often presents with a high eyelid crease.
True
100
Dacryocystitis
Inflammation of lacrimal sac secondary to obstruction within the nasolacrimal duct, leading to back up and stagnation of tears within nasolacrimal duct
* can be acute, chronic, or congenital
101
Symptoms of acute Dacryocystitis
- unilateral pain, radiates to cheek, teeth, face
- swelling and erythema of tissue surrounding lacrimal sac
- mucopurulent discharge from punctum
- concurrent fever and malaise
* can lead to preseptal cellulitis if not treated
102
Symptoms of canaliculitis
- excessive tearing
- mucopurulent discharge
*pouting punctum
103
True or false
There is swelling on the lacrimal sac in canaliculitis
False
* there is no swelling of lacrimal sac
* inflammation of the canaliculus
104
Most effective tx for canaliculitits?
Canaliculotomy
105
Most effective tx for canaliculitits?
Canaliculotomy
106
Tx for acute Dacryocystitis
Augmentin 500 mg po TID for 14 days
* if patient does not report fever
But if pt does become ill then pt should be hospitalized and treated with IV antibiotics (cedazolin)
If chronic, surgery (dacryocystorhinstomy)
107
RTC for acute Dacryocystitis
1 day
* monitor for improvement daily.
If worsens, intervention can occur in a timely manner
108
What is a hordeolum?
An acute infection of the eyelid, commonly known as a stye
## Footnote
Hordeola can be classified as internal or external based on their location and are typically associated with pain.
109
What are the most common pathogens causing hordeola?
Staphylococcus
## Footnote
Hordeola often occur concurrently with blepharitis.
110
How are chalazia different from hordeola?
Chalazia are not infections and are caused by lipogranulomatous material
## Footnote
Chalazia typically cause little to no pain and can grow large, lasting a significant amount of time.
111
What is the primary treatment for chalazia?
Frequent warm compresses and digital massage
## Footnote
Some doctors may prescribe oral antibiotics to treat concurrent meibomitis rather than the chalazion itself.
112
What is dacryocystitis?
An inflammation of the lacrimal sac, which can be acute, chronic, or congenital
## Footnote
It can present with various symptoms depending on its type.
113
What are the symptoms of chronic dacryocystitis?
Unilateral tearing, a mass in the nasal canthal region, intermittent discharge
## Footnote
The mass is typically not tender to the touch and may follow a history of acute dacryocystitis.
114
What are the symptoms of acute dacryocystitis?
Unilateral pain, swelling, erythema of the tissue, mucopurulent discharge
## Footnote
Pain may radiate to the cheek, teeth, or face, and patients may also report fever or malaise.
115
What causes acute dacryocystitis?
Obstruction of the nasolacrimal duct leading to stagnant fluid and infection
## Footnote
This condition can result in a mucopurulent discharge from the punctum if pressure is applied.
116
Fill in the blank: A hordeolum is generally associated with some degree of _______.
pain
117
True or False: Chalazia are typically acute in nature.
False
## Footnote
Chalazia are not acute and usually cause little to no pain.
118
What are the three types of dacryocystitis?
Acute, chronic, congenital
119
What are the signs of chronic dacryocystitis? (3)
Unilateral tearing
mass in the nasal canthal region
intermittent discharge
## Footnote
Typically not tender to touch and often has a history of acute dacryocystitis
120
What symptoms characterize acute dacryocystitis?
Unilateral pain, swelling, erythema, mucopurulent discharge
## Footnote
Pain may radiate to the cheek, teeth, or face
121
What is the most common cause of acute dacryocystitis?
Obstruction of the nasolacrimal duct
122
What infection is most frequently associated with acute dacryocystitis?
Staphylococcal origin
123
What may acute dacryocystitis lead to if not treated timely?
Preseptal cellulitis
124
What are the symptoms of preseptal cellulitis?
Diffuse swelling of the eyelid, tenderness, erythema
## Footnote
Extraocular motility is normal, pain on eye movement is absent, no proptosis
125
What common history do patients with preseptal cellulitis report?
Insect bite, local skin abrasion, concurrent sinusitis
126
What is the most common malignant eyelid lesion?
Basal cell carcinoma (BCC)
* waxy, translucent nodule, rarely metastasizes
127
How does basal cell carcinoma typically present?
Waxy, translucent nodule that eventually ulcerates
128
What do patients often report about their basal cell carcinoma lesion?
It has been there for years and does not seem to heal
129
What should be done if basal cell carcinoma is suspected?
Refer for a biopsy of the tissue
130
Does basal cell carcinoma typically metastasize?
Very rarely
131
Fill in the blank: Preseptal cellulitis causes _______ swelling of the eyelid.
Diffuse
132
What is often prescribed alongside warm compresses and lid massage for MGD?
An oral antibiotic
## Footnote
This is especially common in advanced cases where the patient is symptomatic.
133
What is the initial dosage and duration for tetracycline in treating MGD?
250 mg qi.d. for 1 week then b.i.d. for 6-12 weeks
## Footnote
'qi.d.' means four times a day and 'b.i.d.' means twice a day.
134
What is the initial dosage and duration for doxycycline in treating MGD?
100 mg b.i.d. for 1 week then q.d. for 6-12 weeks
## Footnote
'q.d.' means once a day.
135
What is the dosage and duration for minocycline in treating MGD?
100 mg daily for 6-12 weeks
136
What recent findings have been shown regarding doxycycline dosage?
Decreasing the dosage from 100 mg to 20-50 mg offers the same efficacy
## Footnote
This change also reduces the potential for unwanted side effects.
137
What properties do the oral medications for MGD provide?
Antimicrobial and anti-inflammatory effects
## Footnote
These effects are beneficial for treating eyelid symptoms.
138
What serious pathology should be considered in patients with unilateral, intractable, or asymmetrical blepharitis?
Sebaceous gland carcinoma
## Footnote
Further testing should be performed to rule out this serious pathology.
139
Floppy eyelid syndrome is typically observed in which demographic?
Older, obese males
## Footnote
These patients often complain of foreign body sensation or excessive ocular irritation.
140
What symptoms do patients with floppy eyelid syndrome commonly experience?
Foreign body sensation or excessive ocular irritation
## Footnote
Symptoms are particularly noticeable upon awakening.
141
What is a key characteristic of the eyelids in patients with floppy eyelid syndrome?
Increased laxity that can evert while sleeping
## Footnote
This leads to discomfort and irritation.
142
What skin condition is characterized by persistent scaly, dry skin?
Actinic keratosis
## Footnote
This condition is not exhibited by the patient in the case.
143
Which racial demographic most at risk for developing actinic keratosis?
People with lighter pigmentation and history of excessive ultraviolet light exposure
## Footnote
This demographic tends to be most vulnerable.
*precursor to squamous cell carcinoma
Signs: flat or scaly skin, nodular or papillomatous, pink, flesh colored or red/brown
Tx: biopsy to confirm dx, removed if confirmed
144
What ocular manifestations are characteristic of systemic amyloidosis?
Yellow, waxy nodules in the inferior fornix and small conjunctival hemorrhages
## Footnote
These findings are significant indicators of the condition.
145
How does an amelanotic nevus typically appear?
As a vascularized mass with little (to no) pigmentation
## Footnote
This distinguishes it from pigmented nevi.
146
What organism causes Phthiriasis palpebrarum?
Phthirus pubis
## Footnote
Also known as pubic lice or crabs.
147
How long is Phthirus pubis?
About 2 mm long
148
What examination may reveal P. pubis clinging to eyelashes?
Slit lamp examination
149
What are small brown deposits on the lid margin indicative of?
Feces of P. pubis
150
What may be observed alongside conjunctival injection in cases of Phthiriasis palpebrarum?
Follicles
151
What is a potential symptom of severe cases of Phthiriasis palpebrarum?
Marginal keratitis
152
What are maculae ceruleae?
Dermal blue spots produced at the feeding site by the saliva of lice
153
What organism is frequently found on the dermis near sebaceous glands?
Demodex
154
What percentage of people over the age of 45 possess some form of Demodex?
90-95%
155
What might a clinician observe in moderate cases of Demodex infestation?
Mild inflammation and keratin sleeves along the bases of the eyelashes
156
What are common symptoms reported by patients with Demodex infestation?
Itching and mild ocular irritation
157
What severe symptoms may biomicroscopy reveal in cases of Demodex?
Thickening of the lid margins, erythema, conjunctival injection, and trichiasis
158
What can occur if treatment for Demodex infestation is not initiated?
Corneal neovascularization and marginal infiltrates
159
When are symptoms of Demodex infestation typically worse?
In warm weather
160
What family do ticks belong to?
Arachnid family
161
Where are ticks typically found?
Grassy, wooded areas
162
What diseases may ticks carry?
* Lyme disease
* Rocky Mountain spotted fever
* Tularemia
* Colorado tick fever
163
What are common symptoms of tick-borne diseases?
* Flu-like symptoms
* Fatigue
* Muscle aches
* Nausea
* Vomiting
164
What is the size range of Demodex mites?
0.3 to 0.4 mm
165
True or False: Tick bites are generally serious.
False
166
What is the first step in the proper treatment of P. pubis?
Mechanical removal of all nits and lice with jeweler's forceps
167
What should be done with the nits and lice after removal?
Place them onto an alcohol wipe which is then immediately disposed of
168
What type of ointment is commonly prescribed after removing lice?
Bland ophthalmic ointment such as bacitracin
169
How often should the ophthalmic ointment be applied after lice removal?
ti.d. for 10-14 days
170
Name two other topical treatments effective for P. pubis.
* Malathion
* Mercury oxide
171
What are two physical treatments mentioned for P. pubis?
* Cryotherapy
* Argon laser photocoagulation
172
What is the most widely utilized treatment option for P. pubis?
Mechanical removal followed by ophthalmic ointment
173
True or False: Anti-lice shampoos are approved for ocular use.
False
174
Why can't anti-lice shampoos be applied to the eye?
Due to their high potential for ocular surface toxicity
175
What must be done to all clothes, bath towels, and bedding to prevent infestation?
Launder and dry on high heat, then seal in a bag for 14 days
## Footnote
This process helps eliminate any potential lice or eggs.
176
What is the scientific name for the condition associated with eyelash lice?
Phrhiriasis palpebrarum
## Footnote
This condition refers to the infestation of the eyelashes by lice.
177
How often do the eggs laid by a louse hatch?
Every 7 to 10 days
## Footnote
This rapid hatching emphasizes the importance of thorough cleaning.
178
At what temperature should contaminated items be washed to kill lice?
At least 131 degrees Fahrenheit for 5 or more minutes
## Footnote
This temperature is crucial for effectively eliminating lice and their eggs.
179
What should be done with contaminated items after laundering?
Place them into a sealed air-tight plastic bag
## Footnote
This prevents re-infestation from items that may still harbor lice.
180
What should patients be cautioned about regarding the transmission of the condition?
Avoid sharing any combs, towels, bedding, etc. with others
## Footnote
This helps prevent the spread of infestation to others.
181
What should be done for a patient’s partners from any sexual encounters over the previous month? (Patient had infestation of pubic crab lice in their eyelashes)
They should be evaluated for infestation and possible treatment
## Footnote
Partner evaluation is critical to ensure complete resolution of the infestation.
182
What should patients and their partners avoid until both have been treated?
Engaging in sexual activity
## Footnote
This is important to prevent re-infestation and ensure both parties are clear.
183
What is characterized by the presence of large papillae on the upper tarsal conjunctiva?
Giant papillary conjunctivitis (GPC)
## Footnote
Large papillae are greater than 0.33 mm in size.
184
What history is typically associated with giant papillary conjunctivitis?
Contact lens wear, ocular prosthesis, or corneal surgery with exposed sutures
## Footnote
GPC is most commonly found in soft contact lens wearers.
185
In which type of contact lens wearers is GPC most commonly found?
Soft contact lens wearers
## Footnote
It may also appear in patients wearing rigid gas permeable lenses, but less frequently.
186
What are common symptoms of giant papillary conjunctivitis?
* Contact lens intolerance
* Blurred vision
* Excessive lens movement with blinking
* Pruritus
* Mucous production
* Burning and stinging
## Footnote
General discomfort usually develops after 2-3 years of tolerating contact lenses well.
187
What type of deposits are typically found on the surface of contact lenses in patients with GPC?
* Mucous
* Cellular debris
* Microorganisms
## Footnote
These deposits may play a pathogenic role in the development of GPC.
188
True or False: Giant papillary conjunctivitis can occur in patients wearing rigid gas permeable lenses.
True
## Footnote
However, it occurs much less frequently in these cases.
189
Fill in the blank: GPC is characterized by the presence of large _______ on the upper tarsal conjunctiva.
papillae
190
Hertel exophthalmometer normal values for
Caucasian, Asians and African Americans
White= up to 22mm (11-22 mm)
AA= up to 24 mm (12-24 mm)
Asians = 20 mm (11-20mm)
Normal is 21-24mm
191
Loss of lash pigment
Poliosis
192
Inward turning of lashes towards the globe
Triciasis
193
Abnormally high quantity of lashes
Polytrichosis or hypertrichosis
194
Eyelashes are abnormally long and lush
Trichomegaly
195
Patients of which decent(s) are commonly observed to have epiblepharon?
Asian
Hispanic
