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33 Cards in this Set
- Front
- Back
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The eyelids are composed of which glands?
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1. Meibomian
2. Zeiss 3. Moll |
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T/F: the cornea is avascular
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True
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The conjunctiva is composed of:
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Mucosal surface, avascular
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What are common sx of self-treatable conditions?
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Eyestrain
Burning, itching, stinging Mild discharge Mild redness of eyelid Mild, diffuse redness of conjunctiva |
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Which symptoms usually require referral?
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Pain
Photophobia Altered vision Severe redness of conjunctiva or eyelid Trauma to the eye Floating spots Abnormal pupils Headache Redness around cornea |
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Which scenarios require referral?
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1. Untreated conditions lasting >48h
2. Self-medication >48h with anti-infectives or 3. Self medication >72h with other agents --> no improvement |
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The meibomian gland secrets:
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Sebum; single row of 20-30 run perpendicular to lid margin in each eyelid
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The gland of zeis secretes:
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Sebum; around middle of eyelash follicle
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The gland of moll secretes:
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Sweat; located at base of eye follicle
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Goals of Therapy for blepharitis?
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1. Improve patient comfort (decrease pain, inf, appearance)
2. Reduce risk of recurrences 3. Reduce risk of complications (conjunctivitis, keratitis, altered vision, damage to eyelids and ocular surface) |
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Basic care for blepharitis?
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1. Don't touch eye
2. Don't squeeze lesions 3. Was hands before and after touching eye area 4. Clean towels (1 towel per eye) 5. Eyelid margin hygiene (1-3 drops of baby shampoo in 100ml water, then apply to eyelid; or warm compress 5-10 minutes) |
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Define: allergic or chemical blepharitis
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Blepharitis caused by chemical irritant or hypersensitivity, commonly:
- smoke - plants (poison ivy) - metal - cosmetics - medication (neomycin, pilocarpine, tetracine, timolol) |
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What is the usual cause of infectious blepharitis?
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S. aureus or s. epidermis
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Onset of infectious blepharitis?
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Often chronic and recurring
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Location of blepharitis
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Post or anterior lid margins and associated glands
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Signs and symptoms of blepharitis?
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- bilat, diffuse
- swelling and erythema - possible photophobia - lids may be stuck together after sleep |
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What is posterior blepharitis?
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Inflammation and obstruction of Meibomian gland
- yellow, greasy scales - associated with derm disorders Chronic: posterior lid margin gets thickened |
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What is anterior blepharitis?
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Glands of Moll and Zeis are affected
- anterior lid margins inflamed and red - S. aureus: dry, flaky scales cause tiny ulcerations around eyelashes |
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Why should you refer for infectious blepharitis?
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1. Difficult to diagnose
2. Potential long term complications, such as eyelash loss, disfigured lid margin, and keratitis |
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Non-pharm treatment measures for blepharitis?
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1. Warm, moist compress (5-15 min daily - QID)
2. Lid cleansing (margins only) - acute: BID - chronic: daily to 2x/week |
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Which pharm options should be used for blepharitis?
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OTC ABX (polysporin ointment) or prescription ABX
Acute: QID 1-2weeks Chronic: as above, then continue HS x 4-8 weeks - also use Artificial Tear GEL |
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Pharm options for seborrheic blepharitis?
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Anti-seborrheic shampoo to scalp 1-2x/weekly + artificial tears BID-QID
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Cause of hordoleum (stye)?
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Usually s. aureus
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Onset of hordoleum (stye)?
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Acute
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Location of hordoleum (stye)?
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External (glands of Zeis or Moll) or internal (Meibomian)
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Non-drug measures for hordoleum (stye)?
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Basic care: warm, moist compress 5-15 minutes bid-qid to encourage rupture and drainage.
DO NOT SQUEEZE/ attempt to mechanically rupture --> cellulitis |
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When should you refer for patients with stye?
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1. Basic care ineffective
2. Increased pain 3. >1 stye appears |
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What is the cause of chalazion?
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It is sterile
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Onset of chalazion?
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Chronic
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Location of chalazion?
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Blockage of Meibomian glands caused of collection of sebum when skin is sloughed off
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Signs and symptoms of chalazion?
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- Unilateral, localized
- Pea-sized swelling - Larger than styes - Possible dry eye, visual disturbances - Tends to be over top of eyelid rather than margin |
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What percentage of chalazions will resolve spontaneously?
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25%
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How can chalazion be treated?
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Basic care (warm, moist compresses) and eyelid hygiene to prevent recurrences.
DON'T USE ABX (is sterile cause) Refer if ineffective after 48h |
