Blepharitis Quiz
48 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following is NOT a typical symptom of blepharitis?

  • Photophobia
  • Foreign body sensation
  • Rhinophyma (correct)
  • Worse in the morning

    • What is a characteristic sign related to meibomian gland dysfunction (MGD) often seen with blepharitis?

  • Telangiectasia
  • Madarosis
  • Pannus
  • Foamy meibomian gland secretions (correct)

    • Which of these eyelid abnormalities is characterized by misdirected eyelashes?

  • Trichiasis (correct)
  • Madarosis
  • Ectropian
  • Poliosis

    • What is the recommended initial frequency for lid hygiene as a treatment for blepharitis?

    <p>Twice a day (D)</p> Signup and view all the answers

    Which of the following is NOT a common complication of blepharitis?

    <p>Photophobia (C)</p> Signup and view all the answers

    Besides lid hygiene, what is another recommended non-pharmaceutical treatment approach for blepharitis?

    <p>Warm compresses (D)</p> Signup and view all the answers

    Which topical antibiotic is mentioned as a treatment for blepharitis?

    <p>Chloramphenicol (D)</p> Signup and view all the answers

    Which of these is NOT an eyelash abnormality associated with Blepharitis?

    <p>Telangiectasia (C)</p> Signup and view all the answers

    Which of the following is a characteristic of blepharitis?

    <p>A condition that may be chronic and difficult to manage. (B)</p> Signup and view all the answers

    Which of the following is a predisposing factor for blepharitis?

    <p>Dry eye syndrome (C)</p> Signup and view all the answers

    Anterior blepharitis is typically associated with which primary cause?

    <p>Bacterial colonisation, mainly staphylococcal (D)</p> Signup and view all the answers

    Which of the following is a typical symptom of anterior blepharitis?

    <p>Itching and mild photophobia (B)</p> Signup and view all the answers

    Which of the following is considered a sign, rather than a symptom, of anterior blepharitis?

    <p>Lid margin crusting (B)</p> Signup and view all the answers

    What is the primary cause of posterior blepharitis?

    <p>Meibomian gland dysfunction (C)</p> Signup and view all the answers

    Which of the following is a sign associated with seborrheic blepharitis?

    <p>Oily/greasy deposits on lid margins (C)</p> Signup and view all the answers

    What contributes to the damage associated with posterior blepharitis?

    <p>Immune mediated damage, production of bacterial toxins, waste products and enzymes (B)</p> Signup and view all the answers

    What is the primary distinction between an external and internal hordeolum?

    <p>External hordeolum involves the eyelash follicle and glands of Moll and Zeiss, while internal involves the meibomian glands. (D)</p> Signup and view all the answers

    Which of the following is NOT a common symptom associated with conditions like entropion or trichiasis?

    <p>Excessive tear production (D)</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of a hordeolum?

    <p>Painful lump on the side of the nose (C)</p> Signup and view all the answers

    What is the suggested first-line treatment for a recurrent external hordeolum?

    <p>Chloramphenicol drops (B)</p> Signup and view all the answers

    What is the primary bacterium responsible for causing trachoma?

    <p>Chlamydia trachomatis (A)</p> Signup and view all the answers

    What is the underlying cause of a chalazion?

    <p>Blockage of the meibomian gland ducts. (A)</p> Signup and view all the answers

    Which of these is the most likely cause of involutional entropion?

    <p>Age-related changes (A)</p> Signup and view all the answers

    A patient presents with entropion due to scarring from a previous chemical burn. Which type of entropion is this?

    <p>Cicatricial (A)</p> Signup and view all the answers

    When should you consider a referral to a GP when treating a hordeolum?

    <p>If the patient has a fever (D)</p> Signup and view all the answers

    What is a key characteristic that distinguishes cicatricial entropion from involutional entropion?

    <p>Lid eversion is difficult due to the scarring (B)</p> Signup and view all the answers

    What distinguishes trichiasis from pseudotrichiasis?

    <p>Trichiasis involves misdirected eyelashes, while pseudotrichiasis is due to inward turning of the eyelid. (C)</p> Signup and view all the answers

    Which of the following treatments is considered a temporary solution for entropion caused by lid laxity?

    <p>Taping the eyelid (B)</p> Signup and view all the answers

    Which of the following is a risk factor for the development of a hordeolum?

    <p>Diabetes (C)</p> Signup and view all the answers

    What is a primary cause of trichiasis?

    <p>Scarring of the posterior lid lamella (D)</p> Signup and view all the answers

    What is the main reason why trachoma can lead to blindness?

    <p>Scarring of the tarsal conjunctiva and subsequent trichiasis (A)</p> Signup and view all the answers

    What is the typical incubation period for trachoma after exposure to Chlamydia trachomatis?

    <p>5-12 days (D)</p> Signup and view all the answers

    What is the primary cause of entropion related to lower lid retractor aponeurosis?

    <p>Improper development of the lower lid retractor aponeurosis insertion (A)</p> Signup and view all the answers

    Which of the following is a common symptom of entropion?

    <p>Eyelashes rubbing against the cornea and conjunctiva (A)</p> Signup and view all the answers

    What is the most common cause of ectropion?

    <p>Disinsertion of lower lid retractors due to ageing (A)</p> Signup and view all the answers

    A patient presents with tearing, red and irritated eyes, with constant wiping of the eyes. Which of the following should they be advised to avoid?

    <p>Rubbing their eyes (A)</p> Signup and view all the answers

    Which condition can be caused by scarring of the anterior lamella of the eyelid?

    <p>Cicatricial ectropion (A)</p> Signup and view all the answers

    Which of these can cause paralytic ectropion?

    <p>Cerebellopontine angle tumors (D)</p> Signup and view all the answers

    Which of the following is a sign of pre-septal cellulitis?

    <p>Acute eyelid erythema (C)</p> Signup and view all the answers

    Which of the following is NOT a management technique for entropion?

    <p>Shortening the lower lid (D)</p> Signup and view all the answers

    Which layer of the skin do Basal Cell Carcinomas (BCC) originate from?

    <p>The basal layer (B)</p> Signup and view all the answers

    What is the most common age range in which Basal Cell Carcinoma cases is seen to peak?

    <p>The seventh decade of life (D)</p> Signup and view all the answers

    Which of the following is a typical presentation of a nodular BCC?

    <p>A small, translucent lesion with poorly defined borders (D)</p> Signup and view all the answers

    What is a classic presentation of an ulcerative BCC?

    <p>A nodular lesion with a reddish hue and pearly appearance. (C)</p> Signup and view all the answers

    Which of the following is NOT a typical sign of BCC on the eyelid?

    <p>Hyperpigmented lesion (C)</p> Signup and view all the answers

    Which statement is most accurate regarding Squamous Cell Carcinoma (SCC) of the eyelid?

    <p>It is more aggressive and less common than BCC. (B)</p> Signup and view all the answers

    Which characteristic is NOT associated with a Molluscum Contagiosum lesion?

    <p>It is usually large, at 5-8mm diameter (B)</p> Signup and view all the answers

    Which of the following is a sign or symptom of Thyroid Eye Disease?

    <p>Tachycardia (D)</p> Signup and view all the answers

    Study Notes

    Blepharitis

    • Inflammation of eyelid margins, chronic and can be recurrent
    • Anterior, Posterior, and Mixed lid margin disease
    • Anterior: bacterial colonization (mostly staphylococcal), associated with seborrheic dermatitis (disorder of ciliary glands)
    • Posterior: meibomian gland dysfunction, retention of secretions, blockage of meibomian glands, direct bacterial colonization, immune-mediated damage, bacterial toxins and enzymes
    • Symptoms: ocular discomfort, burning, itching, soreness, mild photophobia, blurred vision, and intolerance to contact lenses. Signs of aqueous tear deficiency, lid margin hyperemia, swelling, crusting, loss of lashes, marginal keratitis, mild papillary conjunctivitis, oily/greasy deposits on lid margins

    Complications of Blepharitis

    • Dry eyes
    • Conjunctivitis
    • Chalazion formation
    • Trichiasis
    • Ectropian
    • Entropian
    • Corneal disease: punctate epithelial erosion, marginal infiltrates, recurrent erosions, marginal ulcers, pannus, keratitis, contact lens intolerance

    Treatment

    • Lid hygiene: cleaning lids with cotton buds, flannel, baby shampoo, or bicarbonate solutions, use of cleaning wipes, avoid cosmetics, reduce to once daily when symptoms improve
    • Warm compresses: 2x daily for 10 minutes
    • Ocular lubricants: symptomatic relief from dry eyes, trichiasis, and entropian
    • Topical antibiotics: chloramphenicol (2x daily after deposit removal for marked lid infection)
    • Oral tetracyclines: if not responding to lid hygiene, especially in patients with acne rosacea
    • Topical steroids: reserved for severe cases or complications with marginal keratitis

    Hordeolum (Stye)

    • Localized infection/inflammation of eyelid margin
    • External: involves eyelash follicle and associated glands, presents as a tender, inflamed swelling on margin
    • Internal: involves meibomian glands within tarsal plate, more painful, may point towards conjunctiva or skin
    • Staphylococcus Aureus infection implicated
    • Symptoms: lid erythema, oedema, pre-septal cellulitis, secondary conjunctivitis
    • Management: warm compress, removal of infected eyelash, topical antibiotics (chloramphenicol for recurrent lesions), referral to GP for fever or tender preauricular lymph nodes or pre-septal cellulitis

    Trichiasis

    • Misdirection of eyelashes towards the globe
    • Different to pseudotrichiasis (eyelashes turn inwards due to entropian)
    • Causes: aging, congenital, scarring of the posterior lid lamella, blepharitis, epiblepharon, past herpes zoster ophthalmicus infection, trachoma, ocular cicatrical pemphigoid, Stevens Johnson syndrome, vernal keratoconjunctivitis, and chemical burns
    • Management of the offending eyelash, tackling underlying conditions, use of therapeutic contact lenses, ocular lubricants

    Trachoma

    • Infection with Chlamydia Trachomatis
    • Begins slowly as conjunctivitis, leads to tarsal conjunctival scarring, distorts upper tarsal plate, causes entropian and trichiasis, causing eye ulcers and possible blindness (in severe cases)

    Entropian

    • Inversion of eyelid, lid margin turned inward toward the globe (Involutional, Cicatrical, Spastic, Congenital)
    • Involutional: age-related, typically lower lid, F > M
    • Cicatrical: scarring or contraction of tissue, pulls lid margin inward due to trauma, chemical burns, infections, etc.
    • Spastic: results from oculomotor issues or issues with the nerves controlling the eyelid motion
    • Congenital: from developmental issues of the lower lid retractor aponeurosis

    Ectropian

    • Outward rotation of the eyelid margin
    • Occurs in 4% of the population over 50 years (sometimes bilateral)
    • Signs: conjunctival hyperemia, corneal exposure, tearing, keratitis, globe apposition, keratinization of palpebral conjunctiva, visual loss, mucous discharge
    • Management: surgery to remove part of lower eyelid, strengthen canthal tendons or inferior lid retractors, use ocular lubricants, bandage contact lenses to prevent eyelash rubbing against cornea, taping lower lid to the cheek

    Pre-septal Cellulitis

    • Common infection of eyelid and periorbital soft tissues, mainly affecting children (80% < 10 years old, most under 5)
    • Symptoms: eyelid erythema, edema, possible fever, tiredness, irritability
    • Separated from the orbital structures by the septum (preventing infection spreading into orbit) which often originates from URTI or paranasal sinus infections.
    • Causes: Staphylococci, streptococci, anaerobes
    • Symptoms: acute pain, swollen eyelid, redness, blurred vision, conjunctivitis, tearing
    • Differential diagnoses: eyelid swelling (insect bites, allergic conjunctivitis, trauma, contact dermatitis, hordeolum)
    • Management: confirm diagnosis, treatment of predisposing conditions, aggressive systemic antibiotics (IV in severe cases or younger children), potential need of CT scan of orbit and sinuses if antibiotics don't improve symptoms.

    Bacterial Orbital Cellulitis

    • Infection of tissues posterior to the septum
    • Mostly spread from surrounding sinuses (often ethmoid) and adjacent structures like the nasolacrimal duct, trauma, surgery.
    • Causative organisms: Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Beta-hemolytic streptococci
    • Symptoms: pain on eye movements, conjunctival chemosis, proptosis, ophthalmoplegia, reduced visual acuity, abnormal RAPD, progressing rapidly and systemically unwell children with fever and malaise.
    • Treatment: confirm diagnosis, IV antibiotics for severe cases/young children

    Tumors (basal and squamous cell carcinoma)

    • Basal cell carcinoma: most common skin cancer, slow growing, destructive, locally invasive, non-healing ulcer (pearly-white borders), lower lid more affected than upper.
    • Squamous cell carcinoma: rarer, aggressive, second most common eyelid malignancy, fair-skinned individuals, history of chronic sun exposure, possible association with other pre-cancerous lesions.
    • Signs may include change in lid contour, redirection/loss of eyelashes, loss of surrounding skin texture, secondary infection/inflammation, threat of sight loss.

    Benign Eyelid Lesions (cysts of Moll, Zeiss, Molluscum contagiosum)

    • Cysts of Moll, Zeiss: sebaceous glands associated with lash follicles, cysts can develop when the follicles are blocked, leading to accumulation of sebaceous material. Cysts are removed for cosmetic reasons.
    • Molluscum contagiosum: benign skin lesion, contagious, spreads with direct contact, presents as dome-shaped waxy nodules (2-3mm), releases toxic viral products, which may lead to follicular conjunctivitis.

    Thyroid Eye Disease

    • Most common in women (40-60s), systemic symptoms (tremor, weight loss), ocular symptoms (proptosis, lid retraction, lid lag, irritation, corneal dryness, lid edema, conjunctival chemosis, optic nerve compression with reduction in vision, colour vision, and visual field loss).

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Eyelid Disorders PDF

    Description

    Test your knowledge on blepharitis with this quiz that covers symptoms, treatments, and related conditions. Questions include characteristic signs of meibomian gland dysfunction and eyelid abnormalities. Perfect for students and professionals in ophthalmology and eye care.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser