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11 Cards in this Set
- Front
- Back
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Eyelid myokymia or benign eyelid twitching management |
1. Rest 2. Elimination or reduction of alcohol, cigarette and caffeine use 3. Spontaneously resolve in a few days to weeks 4. Topical antihistamine e.g. antazoline or pheniramine may be prescribe - q4h - unit dose (SBD) |
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Blepharitis management |
1. Lid hygiene - hot compress: 5-10 min bid-qid - lid scrub using mild detergent cleaner e.g. baby shampoo bid - Avenova (hypochlorous acid 0.01%) eyelid and eyelash cleanser
2. Antibiotic ointment (applied to lid margin) - Bacitracin/ Erythromycin 0.5% ointment bid
3. If patient complaint excessive itching and burning - TrabraDex (tobramycin + dexamethasone) - Zylet (tobramycin + Loteprednol)
4. Unresponsive meibomitis cam be treated with Tetracycline 250 mg po qid or Doxycycline 100 mg po qd for 1 to 2 weeks, then taper slowly until 6 months
5. FU:3-4 weeks |
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Blepharitis in Rosaceae management |
1. Oral Tetracycline 250 mg qid or oral Doxycycline 100 mg bid for at least 2 weeks
2. Oracea: 30 mg of standard Doxycycline + 10 mg of delay-released Doxycycline
3. Erythromycin 250 mg qid if Tetracycline and Doxycycline are contraindicated - discoloration of teeth and bone growth depression - women in last half of pregnancy, nursing mother and children under 8 years of age should avoid Tetracycline
4. Supportive treatment: warm compress, lid expression and lid hygiene (also treat dry eye)
5. FU: variable or as needed |
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Meibomian gland dysfunction management |
1. Mild: relieving any obstruction of the meibomian ducts and orifice by digital massage and gland expression bid to qid
2. Moderate to severe case: oral Tetracycline 250 mg qid or Doxycycline 100 mg po qd initially and then tapered over the course of 3-4 months
3. Low maintenance dosage e.g. 50 mg Doxycycline qd and required long term control
4. Pregnant women and children under 12 year old should use Erythromycin 250mg qid(to prevent bone problem and tooth discoloration)
5. Other machine/tool
- Lipiflow - BlephEx |
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External Hordeolum management |
1. Hot compress several time daily
2. Topical antibiotic to prevent further infection
3. Epilate the involved eyelash
4. Stab incision to drain abscess, then treat with topical antibiotic ointment - e.g. tobramycin or Polymyxin B with Bacitracin (Polysporin) qhs
5. FU: 1 week or prn |
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Internal hordeolum management |
1. Small lesion without significant pain and tenderness, hot compress and lid scrub several times daily
2. Large lesion with significant symptom, oral antibiotic - dicloxacillin (Penicillin resistant synthesis Penicillin) 125-250 mg q6h for 1-2 week - cephalexin 500 mg bid/ qid for 1 week for acute
3. Should rule out preseptal cellulitis |
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Differentiate hordeolum and chalazion (2) |
Hordeolum vs Chalazion 1. Infection vs inflammation 2. Painful vs not pain without pressing Chalazion vs Preseptal/ orbital cellulitis - 一粒瘡 vs 整隻orbital紅曬 |
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Chalazion management |
1. Hot compress and lid massage several times daily for 2-4 week 2. Topical/ systemic antibiotic is not necessary 3. If lesion persist, treat by intraperitoneal injection of steroid 4. If still present, surgery excision - FU 1 week or as needed after the surgery |
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Demodicosis management |
1. Daily lid scrub with 50% tea tree oil (TTO) and lid massage with 5% TTO ointment 2. In office application of ether to the lid margin with a cotton tipped applicator for 5 min |
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Preseptal cellulitis vs orbital cellulitis |
Preseptal cellulitis: infection of the eyelid and periorbital soft tissues that is characterized by acute eyelid erythema and edema
Orbital cellulitis: infection of the orbital content posterior to orbital septum by streptococcus and staphylococcus
Preseptal cellulitis vs orbital cellulitis 1. VA normal vs VA reduced 2. Proptosis absence vs proptosis presence 3. Chemosis mild vs marked 4. Hyperemia mild vs marked 5. Pupil normal vs RAPD 6. Motility normal vs restricted 7. Pain absence vs presence 8. IOP 9. Body temperature 10. Headache 11. Vomiting |
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Preseptal cellulitis and orbital cellulitis management |
Preseptal cellulitis 1. Mild to moderate infection: - dicloxacillin 250 mg po q6h - continue therapy for at least 7-10 days - external lid involvement, topical antibiotic - FU: daily until clear and consistent improvement is noted, then every 2-7 days until condition resolved
Orbital cellulitis: - Nafcillin (IV) and ceftazidime - Ceftazidime and vancomycin: treat severe preseptal cellulitis |
