S2 E063 The Eyeball Part 2 for the PANCE

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Blepharitis

• An infection of the eyelid
• Acute blepharitis is most commonly caused by Staph
• May be viral
• Seborrheic dermatitis or acne rosacea can also cause blepharitis

Clinical Presentation

• Eyelid
  • Loss of eyelashes
  • Red
  • Itchy
  • Burning
  • Scaly
  • Swollen

Labs and Studies

• Slit lamp

Treatment

• Seborrheic dermatitis
  • Clean off scales from
  • Warm wet washcloth with a mild shampoo
• Bacterial infection
  • Topical antibiotic
• Viral infection
  • Oral antivirals

Hordeolum (Stye)

• An acute infection or abscess in the eyelid
• Most commonly caused by Staph
• Localizes to the eyelid margin
• Clinical diagnosis

Clinical Presentation

• My eyelid is:
  • Red
  • Swollen
  • Tender
  • Big bump (Abscess) at the eyelid margin
• Tearing
• Photophobia

Treatment

• Warm compress x 48 hours
• Incision and drainage
• If symptoms do not resolve consider an oral antibiotic

Chalazion

• Cyst of a clogged meibomian gland
• These are less painful than a stye
• Localizes to the body of the eyelid
• Clinical diagnosis

Clinical Presentation

• Over the last several weeks I’ve noticed this growth on my eyelid
• Significant eyelid swelling
• Increased tearing

Treatment

• Warm compresses
• Steroid injection into the lesion
• Surgical excision is a definitive procedure

Entropion

• The eyelid folding inward (inversion of the eyelid)
• Clinical diagnosis

Causes

• Congenital
• Aging – loosening of the muscles and skin
• Scarring
• Trauma

Treatment

• Surgical correction may be necessary

Ectropion

• The eyelid folding outward (eversion of the eyelid)

Causes

• Aging – loosening of the muscles and skin
• Scarring
• Facial nerve palsy
• Trauma

Treatment

• Surgical correction may be necessary

Dacryocystitis

• An inflammation of the nasolacrimal sac
• Usually caused by Staph or Strep
• Clinical Diagnosis

Clinical Presentation

The area of the lacrimal duct is

• Red
• Swollen
• Tender

Labs and Studies

• Culture and gram stain

Treatment

• Warm compresses
• Oral antibiotics