New GP Opthalamology

Question 1

Define blepharitis

Answer 1

Inflammation of the eyelid margins

Question 2

What are the symptoms of blepharitis?

Answer 2

Gritty, itchy, dry sensation in the eyes

Question 3

What is blepharitis associated with and can lead to?

Answer 3

• Dysfunction of the Meibomian glands which secrete meibum (oil) onto the eye surface
• Blepharitis = can lead to styes + chalazions

Question 4

How do you treat blepharitis?

Answer 4

warm compresses and gentle cleaning of the eyelid margins to remove debris (e.g., using a cotton bud and baby shampoo)

Question 5

What is the medical term for a stye?

Answer 5

Hordeolum externum

Question 6

What is hordeolum externum?

Answer 6

Infection of the glands of Zeis or glands of Moll

• Glands of Zeis = sebaceous glands at the base of the eyelashes
• Glands of Moll = sweat glands at the base of the eyelashes

Type of stye

Question 7

How does a stye present?

Answer 7

Tender red lump along the eyelid that may contain pus

Question 8

What is hordeolum internum?

Answer 8

Infection of the Meibomian galnds

Question 9

How does a hordeolum externum stye present?

Answer 9

Tender red lump along eye
Deeper, more painful and may point towards the eyeball underneath the eyelid

Question 10

What are the two types of styes?

Answer 10

Hordeolum externum and internum (more painful)

Question 11

What is the management for a stye?

Answer 11

• Hot compresses + analgesia
• Topical Abx (e.g. chlorophenicol) if conjunctivitis is always present or symptoms are persistant

Question 12

What is a chalazion?

Answer 12

When a meibomian gland becomes blocked + swells
(AKA meibomian cyst)

Question 13

How chalazion (Meibomian cyst) present?

Answer 13

Swelling in the eyelid
* Not typically tender
* (However, can be tender + red)

Question 14

What is the management for a chalazion n(Meibomian cyst)?

Answer 14

• Warm compress + gentle massage towards the eyelashes (to encourage drainage)
• Surgical drainage = rarely required

Question 15

What is entropion?

Answer 15

When the eyelid turns inwards with the lashes pressed against the eye

Question 16

What is the management for entropion?

Answer 16

• First line: taping the eyelid down to prevent it from turning inwards (use lubricating eye drops to prevent eye drying out)
• Definitive management: surgical

Question 17

What is ectropion?

Answer 17

When the eyelid turns outward → exposing the inner aspect

Usually affects the bottom lid

Question 18

What can ectropion lead to?

Answer 18

Exposure keratopathy
(the eyeball is exposed and not adequately lubricated + protected)

Question 19

What is the management for ectropion?

Answer 19

• Mild: regular lunricating eye drops (to protect the eye surface)
• More severe: Surgery to correct defect (risk of sight)

Question 20

What is trichiasis?

Answer 20

Inward growth of eyelashes
Presents with pain

Question 21

What can trichiasis result in?

Answer 21

Corneal damage + ulceration

Question 22

What is the treatment of trichiasis

Answer 22

Removal of eyelashes
Recurrent cases may require:….to prevent them regrowing
* Electrolysis
* Cryotherapy
* Laser treatment

Question 23

What is periorbital cellulitis and how does it present?

Answer 23

Periorbital cellulitis (AKA preseptal cellulitis) = eyelid + skin infection in front of the orbital septum (in front of the eye)

Presentation:
* Swollen, red, hot skin around the eyelid + eye

Question 24

What is the important differential of periorbital cellulitis?

Answer 24

ORBITAL CELLULITIS (sight- and life-threatening emergency)

CT scan = can distinguish between the two

Question 25

What is the treatment for periorbital cellulitis?

Answer 25

**Systemic antibiotics (oral or IV)** Preorbital cellulitis can develop into orbital cellulitis, so vulnerable patients (e.g., children) or severe cases may require admission for monitoring.

Question 26

What is orbital cellulitis?

Answer 26

**Orbital cellulitis** = **infection** around the **eyeball** involving the **tissues behind the orbital septum** Emergency admission

Question 27

How does orbital cellulitis present?

Answer 27

* Pain with eye movement * Reduced eye movements * Vision changes * Abnormal pupil reactions * Proptosis (buldging forward of the eyeball)

Question 28

Management of orbital cellulitis

Answer 28

* IV antibiotics * If abscess forms → surgical drainage