Shared Flashcard Set

Details

Clinical Medicine 1
Eyelashes, Eyelids, and Lacrimal System Disorders
38
Medical
Graduate
08/18/2009

Additional Medical Flashcards

 


 

Cards

Term

 

 

Definition of Hordeolum

Definition

 

 

Acute inflammation or infection of a gland or the eyelid; also called stye

Term

 

 

Etiology of Hordeolum

Definition

 

 

Staphylococcus aureus (most common)

Staphylococcus epidermitis

Term

 

 

Pathophysiology of Hordeolum

Definition

 

Infection of meibomian glands - usually internal and less circumscribed

 

Infection of ciliary glands (Zeis and Moll) - usually external and focal

Term

 

 

Presentation of Hordeolum

Definition

 

 

Pain with palpation

Acutely swollen and edematous eyelid

Normal vision

Term

 

 

Treatment of Hordeolum

Definition

Warm compresses for 10-15 minutes four times a day

 

Usually self-limited infections

 

Incision may be indicated if resolution does not begin within 48 hours

Term

 

 

Definition of Chalazion

Definition

 

 

A non-infectious, granulomatous inflammation of a meibomian or Zeis gland

Term

 

 

Pathophysiology of Chalazion

Definition


Nodule consists of many types of steroid-responsive immune cells, including connective tissue macrophages known as histiocytes, multinucleate giant cells, plasma cells, polymorphonuclear leukocytes and eosinophils


May follow a hordeolum

Term

 

 

Presentation of Chalazion

Definition

 

Hard nodule

Painless

May be in upper or lower eyelid

May follow a hordeolum

Term

 

 

Treatment of Chalazion

Definition

 

25% resolve without intervention

Warm compresses for 10-15 minutes at least 4 times a day

Large or persisting >1 month can refer to ophthamologist for incision and curettage

Term

 

 

Definition of Blepharitis

Definition

Common chronic inflammation of the eyelids

 

Anterior - involves the eyelid skin, eyelashes and associated glands

Posterior - involves the meibomian glands

Term

 

 

Etiology of Blepharitis

Definition

Non-infectious

Occupation that causes dirty hands
Poor hygiene
Seborrhea
Unknown

 

Infectious
Staphylococcal

Term

 

 

Etiology of Blepharitis

(Anterior/Posterior)

Definition

Anterior

Bacteria (Staphylococcus)

Seborrheic dermatitis

Allergy

Psoriasis


Posterior

Dysfunction of the oil (meiborean) gland

Acne roseacea

Seborrheic dermatitis

Allergy

 

Term

 

 

Pathophysiology of Blepharitis

Definition

 

Excess lipid production causes:

Reduced lipid layer of tear

Increased formation of debris

Ideal environment for bacteria

Term

 

 

Risk Factors of Blepharitis

Definition

 

Candida

Seborrheic dermatitis

Acne rosacea

Diabetes Mellitus

Immunocompromised state (AIDS, chemotherapy, etc)

Term

 

 

Presentation of Blepharitis

Definition

 

Itching

Irritation

Burning

Usually worse in morning

Term

 

 

Presentation of Blepharitis

(Anterior/Posterior)

Definition

Anterior

Red rimmed eyes

Scales or granulations at lash base


Posterior

Lid margins hyperemic with telangiectasias

Meibomian glands inflammed/dilated

Lid margin may be rolled inward

Abnormal secretions

Term

 

 

Differential Diagnosis of Blepharitis

Definition

 

Masquerade syndrome

 

-persistent inflammation and thickening of eyelid margin may indicate squamous cell, basal cell, or sebacous cell carcinoma

-any swelling or inflammation of eyelid which does not resolve promptly (within one month) with treatment, is suspect as a possible underlying carcinoma

Term

 

 

Possible Complications of Blepharitis

Definition

 

Hordeolum

Scarring of eyelid margin

Misdirection of eyelashes

Corneal irritation/ulcer

Term

 

 

Treatment of Blepharitis

Definition

 

Eyelid scrubs

For moderate, severe, or chronic cases ophthalmic antibiotic ointment

- Bacitracin or Erythromycin to eyelid margins up to 4 times a day

Term

 

 

Definition of Dacryocystitis

Definition

 

 

 

Inflammation of the lacrimal sac

Term

 

 

Etiology of Dacryocystitis

Definition

 

Most in older population or neonates

Result from

- Chronic mucosal degeneration

- Ductile stenosis

- Stagnation of tears

- Bacterial overgrowth

Term

 

 

Pathophysiology of Dacryocystitis

Definition

 

 

Nasolacrimal obstruction secondary to mucocele of lacrimal sac, which is precipitated by chronic blockage

Term

 

 

Presentation of Dacryocystitis

Definition

Pain

Redness

Tearing

Swelling

Possible fever

Possible purulent discharge from inferior punctum

Secondary conjunctivitis

Usually unilateral

Sudden onset, can be chronic

Term

 

 

Treatment of Dacryocystitis

Definition

 

Warm compresses; massage downward and open up

Systemic antibiotics of febrile

IV antibiotics if infection is severe

In adults, definitive treatment reqauires dacryocystorhinostomy

Congenital obstruction often resolves spontaneously

Term

 

 

Epidemiology of Dacryostenosis

Definition

 

Most common cause of tearing in children <1 year

 

Occurs in up to 20% of all normal newborns

Term

 

 

Pathophysiology of Dacryostenosis

Definition

 

Blockage can occur anywhere in lacrimal drainage system but most commonly at the membraneous blockage of the valve of Hasner (lower valve - why you massage downward)

Term

 

 

Presentation of Dacryostenosis

Definition

 

History of chronic or intermittent tearing

Debris on the eyelashes

Occassionally redness of the conjunctiva

Palpation of lacrimal sac may cause reflux of tears

Term

 

 

Complications of Dacryostenosis

Definition

 

 

 

Dacryocystitis

Term

 

 

Treatment of Dacryostenosis

Definition

Lacrimal duct massage 2-3 times per day by applying downward moderate pressure over lacrimal sac in a downward direction

 

90% resolve spontaneously by 6 months of age

 

If no resolution, refer to ophthamologist for possible lacrimal duct probing

Term

 

 

Quick Overview of Dacryocystocele

Definition

Noted at or shortly after birth

 

Both proximal and distal portions of nasolacrimal system are obstructed

 

Urgent referral to ophthamologist

Term

 

 

Definition of Entropion

Definition

 

 

Inversion of the anatomical eyelid margin towards the globe

Term

 

 

Etiology of Entropion

Definition

 

Pseudo - trichiasis = aberrant lashes because of constant pressure on lashes


Involutional (aging) is most common cause


Cicatricial = scarred (burns, Steven-Johnson Syndrome, surgery)

Term

 

 

Presentation of Entropion

Definition

 

Dry eye

Tearing (inverted puncta)

Cornea irritation

Cosmetic

Term

 

 

Treatment of Entropion

Definition

 

Lubricants

Evert lid with tape

Botox injections for lower lid

Surgery (usually required to avoid damage to the cornea)

Term

 

 

Definition of Ectropion

Definition

 

 

Eversion of the anatomical eyelid margin away from the globe

Term

 

 

Etiology of Ectropion

Definition

 

Paralytic

Usually aging

Cicatricial (burns, surgery)

Mechanical (tumor, herniated fat)

Term

 

 

Presentation of Ectropion

Definition

 

 

Dry eye

Tearing (everted puncta)

Cosmetic

Term

 

 

Treatment of Ectropion

Definition

 

 

Lubricants

Surgery

 

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