eyelid problems

Question 1

what are the eyelid problems commonly encountered?

Answer 1

1. blepharitis: inflammation of eyelid margins typically leading to red eye
2. stye: infection of glands of eyelids
3. chalazion (Meibomian cyst)
4. entropion: in-turning of eyelids
5. ectropion: out-turning of eyelids

Question 2

what are the different types of stye?

Answer 2

1. external
   
   • infection (usu. staphylococcal) of glands of Zeis (sebum producing) or glands of Moll (sweat glands)
2. internal
   
   • infection of Meibomian glands. may leave a residual chalazion (Meibomian cyst)

Question 3

what is the management for stye>

Answer 3

hot compresses and analgesia

topical abx only if associated conjunctivitis

Question 4

what is a chalazion (Meibomian cyst)?

Answer 4

a retention cyst of the Meibomian gland

presents as a firm painless lump in the eyelid

majority of cases resolve spontaneously but some require surgical drainage

Question 5

what is blepharitis?

Answer 5

inflammation of eyelid margins

Question 6

what is blepharitis due to?

Answer 6

either

• meibomian gland dysfunction (common, posterior blepharitis) or
• seborrhoeic dermatitis / stahphylococcal infection (less common, anterior blepharitis)

also more common in rosacea pts

Question 7

what is the function of the meibomian glands?

Answer 7

secretes oil onto the eye surface to prevent rapid evaporation of the tear film

any problems affecting the meibomian glands (e.g. blepharitis) → causes drying of the eyes → irritation

Question 8

what are the features of blepharitis?

Answer 8

• usually bilateral
• grittiness and discomfort around eyelid margins
• eyes may be sticky in the AM
• eyelid margins may be red, swollen eyelids in staphylococcal blepharitis
• secondary conjunctivitis may occur

Question 9

how do you manage blepharitis?

Answer 9

1. hot compresses 2x/day - to soften lid margin
2. ‘lid hygeine’ - mechanical removal of debris from lid margins
   
   • _{cotton wool buds dipped in mixture of cooled boiled water and baby shampoo}
   • _{alt: sodium bicarbonate, a teaspoonful in a cup of cooled water that has recently been boiled}
3. artificial tears - for sx relief in people with dry eyes/abnormal tear film

Question 10

A 73-year-old man complains of a sore right eye.

What is the diagnosis?

Answer 10

entropion

If left untreated this patient may develop a corneal ulcer. The definitive management of entropion is surgical although eye lubricants and tape (to pull the eyelid outwards) may be used whilst awaiting surgery.

Question 11

A 70-year-old man presented with a watering and sore left eye.

What is the diagnosis?

Answer 11

left-sided ectropion