Black eye,

self limited,

deep hemorrhage can cause IOP spike that is sight threatneing. emergent care.

Flame, flash scalding.

Edema can icrease IOP and be self-threatening

supportive TX

if 3rd degree burn consult

assume worst, immediate profuse irrigation, acid- more self-limited.

Neutral: doirrigation 1-2mins
non-netural: do 1-10mins until pH is normal.

then do antibiotic and cycloplegia (to relieve spasm and pain and decrease irits.

Viral skin infxn.

yellowish nodules usually multiple concurrent follicular conjunctivitis and SPK

Tx: excision followed by cautery

Xanthelasama,

Benign cysts and tumors

Greasy!

Plaque-like lipid lesions in middle aged px, more female.

if younger px assoc with hyperlipidemia

crusty like a horn

 a.k.a papilloma = welll demarcated lesion with irregular surface, DISCRETE BROWN GREASY, dark in color, FLAT  stuck-on appearance

pre=cancerous skin lesion leads to squamous cell carcinoma,

elderly fair skinned patients with h/p UV exposure, FLAT

reddish scaly lesion,

seen on tips of ears!

Tx: Biopsy with cryo. (freeze)

Clear, ROUND nodule, by gland of moll, assymptomatic but can lead to trichiasis (inturn of lash)--> complaints and irritation

Tx: Excision (slice, slice scoop &stitch) , DO NOT lance cos lancing (poke hole and drain) has increased recurrence

Sebaceous cyst,

Benign cysts and tumors

occur from hair follicles or sebaceous glands, white to creme colored based on depth,

asymptomatic

Tx: superficial- lance

sub cutaneous- excis

Verrucae Vulgaris or plana,

Benign cysts and tumors

HPV- viral wart, MOST COMMON BENIGN tumor of lids.

Tx: chemical cautery (DO NOT drain or lance because when drained can relaease virus and lead to conjunctivitis.

MOST COMMON malignant eyelid tumor,

usually lower lid, slow growing eats slowly,

Nodular: focalized, pink pearly borders, cricumscribed with central ulcer.

Sclerosing: erodes laterally, hard to differntiate and etch edges, normal anatomy is gone, lack of smooth normal tissue.

Tx: excision with biopsy, then radiation

• prefers lower lid, greater metastasis potential, more aggressive!.

looks benign: scaly plaque -like, nodular, ulcerating, don't be fooled!

• 5-10% of lid malignancies, and elderly individual with fair skin.

• typically arise from pre-existing actinic keratoses (AK), looks like it.

Melanoma, 

Malignant tumors

vascular tumor associated with AIDS

Pink to brown, rapid growing, tend to bleed. so will have a reddish hue,

Tx: Radiation

Blepharospasm,

neurologic and muscular lid disorders

Benign, bilateral involuntary orbicularis spasms, more females, 6th decade of life.

Tx; if debiliatatin botox every few weeks to decrease mucle response

Blepharoclonus,

neurologic and muscular lid disorders

Myokymia, 

neurologic and muscular lid disorders

fasciculations of orbicularis, annoyning twitch of the eye.

c/o: jumping and quivering

Unilateral and self-limited.

Etiology: fatigue, stress, meds, alcohol.

• cool compresses and topical antihistamines give temporary relief.

• Prolong refractory period of mucles so won't quiver use quinine, tonic water

Pseudograefe,

neurologic and muscular lid disorders

aberrant regeneration where MR fibers go to LPS sow when eye is aDducted there is concurrent elevation,

secondary to traumatic CN 3 palsy.

Nerves don't grow along the right track, eye and eyelid will go up when you adduct.

px opens mouth ptosis improves,

5% of congenital ptosis px,

tx: Surgery,

If jaw winking gowes away when mouth opens then congenital