Diseases Of The Eyelid (Parpados)

Front 1

_____ is an absence of eyelid tissue at birth. I mainly involves the upper lid at the middle and third junction.

Back 1

coloboma

Front 2

______ is an extra row of lashes arising from the meibomian gland orifice.

Back 2

Distichiasis

Front 3

Distichiasis is ______ or can occur sporadically.

Back 3

Auto. Dominant

Front 4

Distichiasis may cause ______ and/or _______. (2 general sequelae)

Back 4

corneal staining, corneal hypoesthesia (decreased sensitivity)

Front 5

_______ can be done to remove unwanted eyelashes (pestanos)

Back 5

epilation

Front 6

_______________ is a partial or complete fusion of the eyelid margins with krazy glue.

Back 6

cyanoacrylate tarsorrhaphy

Front 7

Briefy describe the process of patient care for cyanoacrylate tarsorrhaphy.

Back 7

1- light pressure patch soaked in water or mineral oil.
2- reomove the glue with forcepss
3- trim and separate lashes
4- treat the corneal abrasion as normal

Front 8

__________ occurs from an infection of the glands of Zeiss or moll with staph. Will this hurt?

Back 8

External hordeolum, yes

Front 9

What are some treatment methods for an external hordeolum?

Back 9

HOT COMPRESS!!!
antibiotic ung (to prevent surrounding infections)
epilation
stab incision
---may require topical steriods or a systemic antibiotic

Front 10

_______ is a localized staph infection of a meibomian gland. Does this hurt?

Back 10

Internal hordeolum, yes

Front 11

Which type of hordeolum has a longer onset and course?

Back 11

the Internal hordeolum

Front 12

What are 4 antibiotics that are good to treat a hordeolum.

Back 12

1- penicilinase- resistant penicillin (dont give oral V)
2- erythromycin or azithromycin
3- tetracycline
4- cephalosporins

Front 13

______ is a chronic, STERILE, lipgranulomatous inflammation of the meibomian gland. Does this hurt?

Back 13

Chalazion, NO

Front 14

What causes a chalazion?

Back 14

retention of the normal secretions

Front 15

Can a chalazion induce astigmatism?

Back 15

yes

Front 16

IF a chalazion does not go away after a hot compress what can you do?

Back 16

use intralesional steroid injection (aka: Kenalog)

Front 17

What should you think if a chalazion will not go away, or if it keeps recurring?

Back 17

must rule-out sebaceous gland carcinoma

Front 18

Some Drs. required the use of _______ for 6 weeks before performing incision and curettage on a chalazion.

Back 18

tetracycline or doxycyline

Front 19

_________ is inflammation of the eyelid margin.

Back 19

blepharitis

Front 20

What can be used to improve meibomian gland function?

Back 20

tetracycline (due to its anti-inflammatory effects)

Front 21

Staph blepharitis is caused by _____ and _____.

Back 21

staph aureas and epidermidis

Front 22

What are 2 sources of infection of staph blepharitis?

Back 22

Demodex mite (a vector) or mascara

Front 23

Patients with _____ are predisposed to getting staph blepharitis.

Back 23

rosacea

Front 24

What is the most common subclass of staph blepharitis?

Back 24

Squamous--you will hard, brittle and scales and collarettes.

ulcerative is a less common subclass

Front 25

______ is the loss of lashes.

Back 25

Madarosis

Front 26

___________ is a thickened lid margin.

Back 26

Tylosis ciliaris

Front 27

The bacterial of Staph blepharitis will secrete a _________. This will cause:
1-________
2-_________ (mostly found __ and ___)
3-_________

Back 27

Necrotizing exotoxin
1- chronic papillary conjunctivitis
2- corneal limbal infiltration (located inferotemoral and inferonasal)
3- Phlyctenulosis

Front 28

_______ is delayed hypersensitivity to the foreign proteins of bacteria.

Back 28

Phylctenulosis

Front 29

What is a treatment plan for staph blepharitis?

Back 29

hot compress and a lid scrub with JBS. Follow with antibiotic ung

Front 30

Can yellow mercuric oxide treat staph blepharitis?

Back 30

yes

Front 31

_________ is a localized form of seborrheic dermatitis and it seen with greasy, flaky lids and crusty lashes.

Back 31

seborrheic blepharitis

Front 32

Which has a redder lid margin, staph blepharitis or seborrheic blepharitis?

Back 32

staph bleph

Front 33

What is the main form of treatment? What is something that you can wash the eyelashes with?

Back 33

Good hygiene, hot compress
- Selenium Sulfide (selsun)

Front 34

Can you have both staph and seborrheic blepharitis at the same time?

Back 34

yes, this is very common

Front 35

___________ is simply an increase in the amount of secretions without solidification or surrounding inflammation.

Back 35

meibomian seborrhea

Front 36

In meibomian seborrhea you will see ______ in the tear menisus. and ______ with the slit lamp.

Back 36

foam, multiple colors (lots of oil)

Front 37

__________ is stagnation or solidification of meibomian secretions. Is this infectious?

Back 37

Meibomianitis!! NOT infectious

Front 38

If a patient has meibomianitis, what can you Rx for them? Why?

Back 38

oral tetracycline. It improves the function of the meibomian glands.

Front 39

__________ in an infection and inflammation of lateral and sometimes medial CANTHAL regions.

Back 39

Angular blepharitis

Front 40

Angular blepharitis is caused by ________ or staph (as always).

Back 40

Moraxella

Front 41

What are 3 signs of angular blepharitis.

Back 41

1- hyperemia
2- desquamation
3- ulceration

Front 42

What can you use to treat angular blepharitis caused by moraxella?

Back 42

Zinc sulfate

Front 43

What defines the septum on preseptal cellulitis.

Back 43

aponeurosis and tarsal plate

Front 44

______ is an infection and inflammation of lid structures anterior to the orbital septum.

Back 44

preseptal cellulitis

Front 45

What are 3 ways to get preseptal cellulitis?

Back 45

1- penetrating trauma
2- spread from adjacent infection
3- extension of inter/external hordeolum

Front 46

Can preseptal cellulitis turn into orbital cellulitis? What is the most common cause of orbital cellulitis?

Back 46

yes, sinus infections

Front 47

What are 7 great ways to differentiate b/t preseptal and orbital cellulitis?

Back 47

1- proptosis
2- vision
3- pupils
4- motility
5- pain on movement
6- IOP
7- temperature

Front 48

_______ probably causes preseptal cellulitis in kids.

Back 48

Haemophilus Gram -

Front 49

What "test" must you always consider when the preseptal cellulitis is caused by a penetrating injury?

Back 49

Tetanus immunization. They must have had the shot in the last 5 years.

Front 50

____________ is an eyelid infestation by 3 kinds of lice.

Back 50

phthiriasis palpebrarum

Front 51

________ is eyelid infestation of the Pediculus species.

Back 51

Pediculosis

Front 52

Phthiriasis is usually caused by _____ lice (its all about the hair diameter)

Back 52

pubic

Front 53

Can yellow mercuric oxide ung be used to treat phthiriasis?

Back 53

yes (you want to smother the louse)

Front 54

What are 2 medications that can treat body lice. Can these be put into the eyelashes?

Back 54

1- kwell
2- Rid

NO!!!!!!!

Front 55

______ is a drooping of the upper lid.

Back 55

ptosis

Front 56

Congenital ptosis is _____ and is usually caused by a problem with the levator.

Back 56

autosomal dominant

Front 57

What are 6 causes of acquired ptosis.

Back 57

1- horners
2- CN III palsy
3- Myasthenia gravis
4- trauma
5- mechanical
6- thiamine deficiency in childhood

Front 58

What are some causes of pseudoptosis?

Back 58

1- microphthalmia
2- phthisis bulbi
3- anophthalmia
4- enophthalmos
5- dermatochalasis
6- lid cellulitis

Front 59

What can you do to confirm horners?

Back 59

Drop 2.5% phenylephrine 9 gt onto the eye. The eyelid on the affected side should elevate to confirm horners

Front 60

___________ injected should produce elevation of a ptotic lid if the condition is Myas. Gravis.

Back 60

edrophonium chloride

Front 61

If you get a cholinergic reaction with the tensilon test, what can give to correct it?

Back 61

atropine (an anti-cholinergic)

Front 62

What are 2 medications used as therapy for myasthenia gravis?

Back 62

1- neostigmine bromide
2- pyridostigmine bromide

oral prednisone if these dont work

Front 63

________ is fasciculations of the orbicularis.

Back 63

eyelide myokymia

Front 64

What can you give for persistent eyelide myokymia?

Back 64

1- topical antihistamine
2- oral antihistamine
3- oral quinine (do NOT give to pregnant women as it causes abortion.
4- gin and tonic (has quinine)

Front 65

__________ is chronic and prgressive bilateral involuntary contraction of the orbicularis.

Back 65

essential blepharospasm

Front 66

________ innervates the orbicularis.

Back 66

CN VII (think bells palsy)

Front 67

Essential blepharospasm mostly affects _____ in their ______ decade.

Back 67

females, 5th or 6th

Front 68

A CNS ______ imbalance may cause essential blepharospasm.

Back 68

dopamine (think parkinson)

Front 69

What is a common treatment for essentail blepharospasm?

Back 69

botox injections (this blocks the release of Ach from the nerve terminals and thus the orbicularis can not contract) Note: all muscles innervated by Ach will have side effects.

Front 70

________ is the inability to funnly close lids

Back 70

lagophthalmos

Front 71

Can a VII palsy cause lagophthlamus?

Back 71

yes!

Front 72

Anything that causes keratis will probably also cause ______.

Back 72

hypoesthesia

Front 73

_______ can cause inferior punctate keratitis.

Back 73

incomplete blinking

Front 74

_____ is the spilling of tears onto the cheek.

Back 74

epiphora

Front 75

______ is the most common cause of ectropion.

Back 75

involutional (aka: senile)

Front 76

_______ ectropion is secondary to scarring of the skin.

Back 76

cicatricial

Front 77

A major clue that ectropion is cicatricial is when the patient _________ - the ectropion is accentuation.

Back 77

opens his mouth!!

Front 78

__________ is when the eyelid is esily everted (upper lid) due to the loss of tarsal integrity. Happens mostly during sleep.

Back 78

floppy eyelid syndrome

Front 79

Floppy eyelid syndrome occurs mostly in ______ ___.

Back 79

middle aged men

Front 80

Will you see chronic,thick, mucoid discharge in floppy lid syndrone?

Back 80

yes

Front 81

You can give _____ to tighten a lower lid in entropion.

Back 81

collodion