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130 Cards in this Set
- Front
- Back
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Outward turning of lid margin
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ectropion
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what are the 3 main causes of ectropion?
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1. involutional
2. cicatricial 3. paralytic - Bell's Palsy |
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What is the main complication arising from ectropion?
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conjuctiva and cornea are exposed causing irritation and secondary infection
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What is the treatment options for ectropion?
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Lubricants
Taping lids Prophylactic AB ung Surgery |
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Inward turning of lid margin
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entropion
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What are the 4 main causes of entropion?
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1. congenital - epibelpahron
2. involution 3. cicatricial 4. spastic |
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What is the main complication of entropion?
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trichiasis and irritation and/or corneal ulceration
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What is the treatment options for entropion?
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epilation
lid taping lubrication prophylactic AB ung surgery |
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What is the mechanism of Floppy eyelid syndrome?
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lost of elastin of the tarsus causes the superior upper lid to spontaneously evert
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When does Floopy eyelid syndrome occur?
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during sleep
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What occurs during floppy eyelid syndrome?
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upper lids spontaneously evert causing the palpebral conjunctiva to rub against bedding
lids are soft and rubbery due to loss of elastin |
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What are the main complications of floppy eyelid syndrome?
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chronic papillary conjunctivitis and punctate keratitis
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What is the chief complaint of somebody with floppy eyelid syndrome?
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FBS, irritation, and increased mucous discharge upon waking
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How do you treat floppy eyelid syndrome?
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Lid taping or shiedl at night
AB ung Surgery |
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Who typically has floppy eyelid syndrome?
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obese males
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lagophthalmos is...
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incomplete lid closure during relaxed lid closure
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The main cause of lagopthalmos is?
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physiologic/nocturnal
occurs during sleep |
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Lagopthalmos can also arise from what?
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1. proptosis (orbital)
2. mechanical (scaring of lid muscles) 3. paralytic (Bell's palsy) |
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Chief complaint of patient with lagopthalmos
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FBS and irritation in the morning
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What are the complications of lagophthalmos?
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PEK of inferior cornea
Dry eyes severe --> corneal melting |
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Treatment of lagophthalmos includes
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bland lubrication ung
AT tape lids if severe AB ung, bandage CL, surgery if due to Bell's --> oral steroids |
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What is a dropping of the upper lid called?
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Ptosis
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Mechanism of acquired ptosis
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abnormality of the levator muscle or its innervation
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traumatic ptosis occurs secondary to
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surgery
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neurogenic ptosis can be due to...
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Horner's syndrome
3rd Nerve palsy Aberrant regeneration due to faulty nerve supply to LPS or Muller's muscle |
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myogenic ptosis is due to....
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Myasthenia gravis
Muscular dystrophy |
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mechanical ptois are due to...
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tumors - neurofibroma
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involutional ptosis are due to....
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blepahrochalashis - caused by disinertion of the levator aponeurosis
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Congenital ptosis can be due to....
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myogenic
neurogenic aponeurotic |
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developmental anomaly of LPS causing lid lag in downgaze - affected eye is higher in downgaze
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congenital ptosis
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How do you evaluate a ptosis?
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measure lid position
assess action of LPD assess the orbicularis muscle paplpate for mass |
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How do you differentiate between an acquired and congential ptosis?
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look at the lid position in downgaze
congential - lid lag due to inelasticity acquired myogenic - affected lid is lower on down gaze |
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What must be ruled out if there is a history of muscle weakeness?
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MG
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Treatment of congenital ptosis
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monitor
surgery |
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Treatment of acquired ptosis
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sugery
ptosis crutch prosthesis |
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small round translucent elevated mass caused by blockage of ducts of gland of Moll
benign |
Sudoriferous cyst (Cyst of Moll)
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opaque fluid filled mass located at lid margin
benign |
Cyst of Zeis
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yellow white multiple lumps in skin with a central punctum that looks like a blackhead
benign |
Sebaceous cyst
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multiple sebaceous cysts are called
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millia
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plaque like elevated yellowish lesion that are benign, bilateral and tend to occur at medial aspect of upper eyelids
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xanthelasma
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Who tends to have xanthelasma?
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older females>makes
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What should be the work up for a young patient with xanthelasma?
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lipid work up
high risk cardiovascular hx |
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What should be ruled out in young patients with xanthelasma?
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high cholesterol
arteriosclerosis cardio problems |
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Is surgery an option for xanthelasma?
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reoccur
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nonsecreting contagious papillomatous wart that can be smooth or have a rough petal/cauliflower appearance and are gray-brown/yellow in color
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verrucas
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what is the etiology of veruccas
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viral in orign - HPV
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are verrucas contagious
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yes
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veruca that is rough and pedunculated is called
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veruca vulgaris
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veruca that is flat is called
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veruca plana
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Are verucas reoccurrent?
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yes
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Treatment of veucca
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none unless ocular/cosmesis isues
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congenital absence of a portion of the eyelid
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lid coloboma
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where do lid colobomas tend to occur?
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upper lid at the medial middle 1/3 of the eyelid
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what is the most serious complication of a lid coloboma?
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exposure keratopathy when more than 30% of lid is missing
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how do you treat a lid coloboma?
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protect cornea with AT nad Ab ung
surgery |
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accessory row of eyelashes posterior to normal lashes
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distichiasis
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where does the second row of lashes arise from in distichiasis?
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meibomina gland orifices
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describe the appearance of accessory lashes
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smaller shorter and more delicate
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what is the main complication of distichiasis
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corneal staining due to trichiasis
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treatment of distichiasis
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epilate
lubricate conrea if severe surgery |
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essential blepharospasm
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chronic and progressive symmetrical involuntary lid closure
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small papular lesion which expand to form excavated lesiosn with debris inside - chessy core when active
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molluscum contagiousm
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cause of molluscum contagoiousm
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viral wart due to pox virus
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mollouscum contagiousm frequency and severity is high amongst what patients
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HIV positive
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where does mollouscum occur and do they go away?
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occurs at lid margin and other places on body
they spontaneously involute without scarring |
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what is a ddx for molloscum contagiousm?
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Basal cell carcinoma
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what is the main complication that can rise from molloscum?
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virus filled debris from the lesion goes into tear film causing follicular conjunctivitis and keratitis leading to PEK or SEI.
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treatment of molloscum
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excise
clean out central core |
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involuntary contractions of orbicularis muscle leading to uncontrolled blinking, twitching, or lid closing
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blepharospasm
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eyelid tremors; spontaneous twitching made worse by dz, fatigue, or stress
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myokymia
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treatment of blepharospasm
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botox
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treatment of myokymia
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antihistamines - oral & topical
quinine |
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misdirected lashes
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trichiasis
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what is the main complication of trichiasis
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corneal ulceration
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treatment of trichiasis
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epilation
AT and prophylactic AB |
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ulceration of the canthal region causing irriiation and tenderness of affected region
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angular blepharitis
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Angular blepharitis is cuased by what agents
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MORAXELLA & Staph
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what is the treatment of angular bleph caused by moraxella
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zinc sulfate ung
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noninfectious chronic and sterile lipogranulomatous inflammation of MG due to retention of oil secretion
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chalazion
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describe a chalazion
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hard immobile nontender lump
causes no pain |
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treatment of chalazion
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hot compresses
steroid injection - kenalog 10 surgery |
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acute staph infection of the glands of Zeis and Moll
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external hordeolum
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describe an external hordeolum
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localized area of inflammation - redness, tenderness, and inflammation at lid margin
hurts ACUTE onset |
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tretament of external hordeolum
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hot compresses 5- 10 min - heat hastens pointing
topical AB ung drain |
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localized staph infection of blocked MG
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internal hordeolum
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describe an internal hordeolum
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localized pain - severe pain and warm sensation of lid with painful nodule within lid
more prolonged course and onset |
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treatment of internal hordeoulum
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warm compresses
topical AB oral AB recheck with 2-3 days to R/O preseptal cellulitis |
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stagnation/solidifcation of Meibomian secretions
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MGD
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eyelid infestation by pubic lice
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phthriasis/pediculosis
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what causes the inflammatory reaction seen in phthiriasis/pediculousis
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toxic fecal & saliva excretions of the lice
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treatment for pediculosis
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proper hygeine
RID and Kwell (rx) stye ung - yellow mercuric oxide bland ung remove knits |
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generalized inflammation of lid structures anterior to the oribital septum
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preseptal cellulitis
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what are the 2 common pathogens that cause preseptal cellulitis
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hemophilus influenzed in kids < 6
strep |
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what is the main concern in preseptal cellulitis
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orbital cellulitis - affects CNS and meninges
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describe preseptal cellulitis
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lid swelling redness, warm and tender with pain
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H influenzae is common in ____ and looks like ____
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kids
if under 4 looks like a dark purple discoloration |
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H influenzae can cause
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fever
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Prespetal cellulitis is most common in what population
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pediatric
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orbital cellulitis
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- marked lid swelling, chemosis
-proptosis -EOM limitation -pain -decrease VA -APD |
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orbital cellulitis requires what type of tx
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STAT referal/hospitilization
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treatment of preseptal cellulitis
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oral AB - amoxicillin if staph, cephalosporin if hemophilus
follow daily until improved |
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crustingof lids and lashes that aregreasier and is associated with a generalized seborrheci dermatistis
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seborrheic blephartis
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treatment of seborrheic blep
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lid hygeine
Selsun oral doxycycline or tetracycline refer to PCP |
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inflammation of lid margin with crusting caused by staph
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staph bleph
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asymptomatic mildly irritating lid lump causing ulceration, inflammation, distortion or normal lid structure
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malignant eyelid tumors
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most common malignant tumor of eyelid affecting middle age to elderly patients
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basal cell carcinoma
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flesh colored with variable pigmentation with pearly borders and ulcerated center - telangiecstatic vessels at border
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basal cell carcinoma
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does basal cell carcinoma metastasize
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no, but it is locally invasive
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how does basal cell carcinoma arise and where are they commonly seen
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UV
lower lid |
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scaly erythematous(red) lesion with central ulceration with elevation - 2nd most common carcinoma
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squamous cell carcioma
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where is squamous cell carcinoma typically seen
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upper lid
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who is most likely to have squamous cell carcinoma
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fair skinned older adults on sun exposed areas
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is squamous cell carcinoma metastatic
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yes, FATAL, metasis to lymph nodes
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premalignant lesion that can turn into squamous cell carcinoma
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actinic keratosis
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elevated lesion that looks like a chalazion or bleph arising from MG located on upper and lower lids leading to loss of lashes and destruction of MG orifices
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sebaceous gland carcinoma
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can sebaceous gland carcinoma metastasize
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yes
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when should you suspect sebaceous gland carcinoma
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in recurrent cases of belph or chalazion
look for G destruction and loss of lashes`` |
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flat raised nonmalignant lesion with distinct borders
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dermal nevus
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flat lesion with distinct borders that can lead to malignant melanoms
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junctional nevus
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darkly pigmented lesion with irregular borders that can vary in size but is usually > 6mm; arises de novo or from preexisting nevi
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malignant melanoma
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metastasis from malignant melanoma from primary sources are
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breast or lung
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pink and dark purple nodules of plaque seen in AIDS patient
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kaposi's sarcoma
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rapidly growing epithelial lesion with central core of keratin that grows for 3 months and then resolves
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keratoancanthoma
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keratoacanthoma can lead to ___ if not excised
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squamous cell carcinoma
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localized and generalized mass with vascular changes coming from capillaries; resolves spontaneously but becomes worse when cry
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hemangioma
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yellow rough crusty lesion that bleeds easily
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actinic keratosis
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actinic keratosis is premalignant for`
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squamous cell carcionoma
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DDx of actinic keratosis
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sebaceous keratosis
actinic is greasier |
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How long does it take Bell's palsy to resolve?
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6 months
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describe seborrheic keratosis
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elevate brown black lesion well circumsized and crust like; greasy looking; benign
ddx: actinic keratosis |
