LIDS/LASHES - EYELID/LASHES DISORDERS Flashcards
(52 cards)
1
Q
dermatochalasis symptoms?
A
Symptoms:
* Brow ache
* “heavy” sensation
2
Q
signs of dermatochalasis?
A
- Eyelid ptosis / Pseudoptosis
- Advance cases – superior VF defect
3
Q
tx for dermatochalasis
A
blepharoplasty – surgical removal of excessive eyelid tissue
4
Q
define ectropion and what are the causes?
A
- It is eversion (outward) rolling of the lid away from the globe
Causes:
* Involutional (most common)
o Age related loss of muscle tone of the orbicularis oculi.
* Cicatricial
o Due to scarring and contracture (trauma, burns).
* Paralytic
o Due to facial nerve palsy.
* Mechanical
o Lesion or tumor-related.
5
Q
symptoms of ectropion
A
- epiphora w/ ocular irritation
6
Q
signs of ectropion
A
- exposure keratopathy
- eyelid not apposed to the globe
7
Q
tx for ectropion
A
- surgery to tighten the lateral tarsal
- exposure keratopathy should be tx
- if bells palsy is the cause – will resolve spontaneously
8
Q
define entropion and causes of it.
A
- It is inversion of the eyelid towards the globe.
Can be:
* Involutional (most common)
* Congenital (rare)
* Cicatricial -Trachoma
9
Q
symptoms of entropion
A
- ocular irritation (FBS)
- epiphora
10
Q
signs of entropion
A
- eyelid will be rolled inward
- Punctate keratitis
- Corneal ulceration (severe)
- Pannus (chronic)
- Pseudo-trichiasis
11
Q
tx for entropion?
A
- corneal defect – topical Abx ung
- rolled inward lid – surgery
12
Q
define trichiasis and cause of it
A
- misdirected eyelashes which mechanically rub the globe
- causes: idiopathic / epiphora
13
Q
symptoms of trichiasis
A
- ocular irritation (FBS)
- epiphora
14
Q
signs of triachasis
A
- misdirected eyelashes
- PEE
- conj injection
- corneal scarring – severe cases
15
Q
tx of triachasis
A
- 1st line – epilation
- chronic cases – permanently remove eyelashes surgically
- for corneal compromises – rx topical abx ung
16
Q
define blepharospasm
A
- idiopathic bilateral uncontrollable closure of the eyelids
17
Q
signs of blepharospasm
A
- uncontrallable contraction of the orbicularis oculi and surrounding facial muscles
- severe – if examiner unable to open to pry eyelids open
18
Q
tx for blepharospasm
A
- botox injections every 12 wks
side note: botox relaxes the overactive muscles
19
Q
define floppy eyelid syndrome
A
- It is increased/excessive upper & lower eyelid laxity which causes spontaneous eyelid eversion
20
Q
who gets floppy eyelid syndrome?
A
- Most common in obese men
& face-down sleeper, with their eye(s) pressed against the pillow.
21
Q
what sysmtic dz is floppy eylid syndrome associated with?
A
- obstructive sleep apnea
- DM
- HTN
22
Q
symptoms of floppy eyelid syndrome?
A
- Chronic bilateral/unilateral red eyes in the morning upon awakening.
- Mild mucous discharge
23
Q
signs of floppy eyelid syndrome?
A
- Papillary conjunctivitis – from friction
- Loose upper eyelids that evert easily.
- Punctate epithelial keratopathy
24
Q
tx floppy eyelid syndrome?
A
- refer to r/o sleep apnea
- tape eyelid shut or wear eye shield during sleep – tx for eyelid closure
- ATs gtts Q1H during the day + ATs ung QHS – for dryness & irritation
- topical abx ung – for corneal or conj compromise
25
signs of xanthelasma
* creamy yellow plaques found in the supeior nasal eyelids
26
what are the yellow plaques in xanthalasma composed of?
* fat/lipid & cholesterol deposits
27
what is xanthalasma associated with & who gets it?
* pts over <40 y/o with hyperlipidemia
* hypercholesterol
28
tx for xanthalasma
* no tx indicated
* cosmesis -- surgically excise or remove plaques via carbon dioxide laser — can recur
29
define chalazion
* Chronic, localized, sterile inflammation of a MG due to retention of normal secretions
30
signs of chalazion
* Hard, painless, immobile nodule -- more commonly located on upper lid.
31
tx for chalazion
* 1st line -- warm compress
* if persist for more than a month -- remove via biopsy
* if it cont to recurr in same location suspect sebaceous gland carcinoma & refer for biopsy
32
what is a chalzion associated with?
sebaceous gland carcinoma
33
define hordeolum
* acute bacterial infection of the sebaceous glands
34
symptoms for hordeolum
* pain
* eyelid tenderness
35
signs of hordeolum
* unilateral
* red, swollen, tender
possible pointing.
36
tx for hordeolum
* 1st line -- hot compress + topical abx or topical abx-steroid combo
37
define blepharitis? what causes it?
* It is inflammation of the eyelid margin due **staphylococcus** infx
38
what microorganisms cause anterior blepharitis
* Staphylococcal
* Seborrheic dermatitis
* Demodex
39
what microorganisms cause posterior blepharitis
* Staphylococcal
* Seborrheic dermatitis
* MG dysfunction
40
anterior vs posterior blepharitis?
anterior -- glands of zeis & moll
posterior -- MG
41
what can blepharitis cause?
evaporative dry dz -- due to abnormal lipid production
42
symptoms of blepharitis
* dry, burning, itchy, stinging, teary, eye
* FBS
* symptoms are worse at night, when its windy or after reading/watching tv
43
signs of blepharitis
* Possible scurf and collarettes at lash base
* "tooth paste" MG secretion
* red, inflamed lid margins
* PEE
44
tx for blepharitis
* lid hygiene + hot compress + OTC ATs
* Rx erythromycin ung or oral Doxycycline (for MGD + abx)
* for inflammation + dryness -- Xiidra or restasis
45
what is pediculosis/phthiriasis
* it is an eyelash infection caused by lice (phthirus pubis)
46
if pediculosis/phthiriasis is seen in a child, suspect what?
sexual abuse - bc it mainly spreads sexual
47
symptoms of pediculosis/phthiriasis
* burning
* itching
48
signs of pediculosis/phthiriasis
* burrowing lice at base of eyelashes
* spots of dried blood from bites at base of eyelashes
* tiny brown deposits (feces) at base of lashes
* white/translucent nits (eggs) at base of lashes
* possible preauricular lymphadenopathy
49
tx of pediculosis/phthiriasis
* remove lice with jewelwer's forceps
* rx abx ung (erythromycin) for 2 wks
* edu pt to wash towels and linens
* tx pt's sexual partner
* if child presents with pediculosis -- assume sexual abuse and report to authorities.
50
what is demodicosis (demodex)
* infection of the lids/lashes that is caused by demodex
51
signs of demodex
* same as blepharitis but with triangular globs of waste at the base of the patients lashes
52
tx for demodex
* lid hygiene
* Tee tree oil
