Entropion Overview
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Questions and Answers

What value in the Schirmer 1 test indicates an abnormal measurement for dry eye symptoms?

  • 10 mm (correct)
  • 18 mm
  • 12 mm
  • 15 mm

    • Which condition can the Schirmer 1 test help diagnose in a patient experiencing dryness of the eyes?

  • Glaucoma
  • Keratoconjunctivitis sicca (correct)
  • Blepharitis
  • Allergic conjunctivitis

    • Why is the Schirmer 1 test performed without anesthetic?

  • To prevent interference with reflexes
  • To measure reflex tearing accurately (correct)
  • To eliminate discomfort caused by drying
  • To improve patient comfort

    • Which of the following is a potential limitation of the Schirmer 1 test?

    <p>All of the above</p> Signup and view all the answers

    What duration is typically used for the Schirmer 1 test to determine tear production?

    <p>5 minutes</p> Signup and view all the answers

    What is the primary characteristic of entropion?

    <p>Inward turning of the eyelid towards the globe</p> Signup and view all the answers

    Which condition can cause entropion to develop?

    <p>Age-related changes in eyelid tissue</p> Signup and view all the answers

    What condition is characterized by eyelashes turning inward and rubbing against the cornea?

    <p>Trichiasis</p> Signup and view all the answers

    What aspect of entropion could potentially lead to complications?

    <p>It causes the eyelashes to rub against the cornea</p> Signup and view all the answers

    Which of the following is least likely to be associated with entropion?

    <p>Persistent dryness of the eyes</p> Signup and view all the answers

    Which of the following best explains the secondary cause of trichiasis?

    <p>Entropion of the upper and lower lids</p> Signup and view all the answers

    What is a common treatment option for entropion?

    <p>Surgical correction to reposition the eyelid</p> Signup and view all the answers

    What is a common consequence of untreated trichiasis?

    <p>Corneal abrasion</p> Signup and view all the answers

    Which symptom is NOT associated with trichiasis?

    <p>Increased visual acuity</p> Signup and view all the answers

    In which population is trichiasis due to entropion most likely to occur?

    <p>Older adults with age-related changes</p> Signup and view all the answers

    What is the appearance of concretions in the ocular adnexa?

    <p>Chalky, white/yellow inferior sub-conjunctival deposits</p> Signup and view all the answers

    In which demographic are concretions most commonly found?

    <p>Elderly patients or those with chronic meibomian gland dysfunction</p> Signup and view all the answers

    What is a major contributing factor to the formation of concretions?

    <p>Chronic meibomian gland dysfunction</p> Signup and view all the answers

    Which of the following is NOT a characteristic of concretions?

    <p>Occurrence primarily in young adults</p> Signup and view all the answers

    What color variations can concretions display?

    <p>White and yellow</p> Signup and view all the answers

    What characterizes distichiasis?

    <p>Eyelashes originating from meibomian gland orifices.</p> Signup and view all the answers

    Which condition occurs when eyelashes grow inward from their normal position without entropion?

    <p>Trichiasis</p> Signup and view all the answers

    What is a common cause of madarosis?

    <p>An infectious condition or congenital factors</p> Signup and view all the answers

    Which condition is NOT classified as having inward-growing lashes?

    <p>Madarosis</p> Signup and view all the answers

    What is a potential cause of trichiasis?

    <p>Eyelid trauma or surgery</p> Signup and view all the answers

    What is primarily affected in meibomian gland dysfunction?

    <p>Sebaceous gland function</p> Signup and view all the answers

    Which symptom is most commonly associated with meibomian gland dysfunction?

    <p>Frothy tear film</p> Signup and view all the answers

    Meibomian gland dysfunction is also known as which of the following?

    <p>Posterior blepharitis</p> Signup and view all the answers

    What is a potential consequence of untreated meibomian gland dysfunction?

    <p>Corneal ulcers</p> Signup and view all the answers

    What type of glands are primarily dysfunctional in meibomian gland dysfunction?

    <p>Sebaceous glands</p> Signup and view all the answers

    What abnormal eyelash condition is characterized by eyelashes growing from the meibomian glands?

    <p>Distichiasis</p> Signup and view all the answers

    Which condition is characterized by the inward turning of eyelashes, causing irritation to the eye?

    <p>Trichiasis</p> Signup and view all the answers

    Which of the following conditions could cause a sensation of a foreign body in the eye due to eyelash misalignment?

    <p>Distichiasis</p> Signup and view all the answers

    In what condition might a patient notice excessive tearing and irritation due to abnormal eyelash growth?

    <p>Distichiasis</p> Signup and view all the answers

    Which condition is associated with the loss of eyelashes, potentially impacting eye comfort?

    <p>Madarosis</p> Signup and view all the answers

    What defines symblepharon in relation to ocular anatomy?

    <p>It involves adhesion between palpebral and bulbar conjunctiva.</p> Signup and view all the answers

    Which eyelids are primarily affected by symblepharon?

    <p>Usually the lower eyelid.</p> Signup and view all the answers

    In the context of symblepharon, what does 'partial adhesion' imply?

    <p>Adhesion covering only a portion of the conjunctiva.</p> Signup and view all the answers

    What are potential causes of symblepharon?

    <p>Trauma, infection, or inflammation.</p> Signup and view all the answers

    How might a clinician diagnose symblepharon?

    <p>By observing adhesions during ocular examination.</p> Signup and view all the answers

    What is the approximate length of a phthiriasis organism?

    <p>2mm</p> Signup and view all the answers

    Where are phthiriasis organisms typically observed during a slit lamp exam?

    <p>Clinging to the base of the eyelash</p> Signup and view all the answers

    What shape is the body of phthiriasis described as?

    <p>Broad and flat</p> Signup and view all the answers

    In which anatomical location can phthiriasis be found?

    <p>Buried within the eyelid margin</p> Signup and view all the answers

    Which of the following is NOT a characteristic of phthiriasis?

    <p>It is typically found on the scalp</p> Signup and view all the answers

    Which treatment is used for corneal pseudodendrites or superficial punctate keratitis (SPK) in herpes zoster ophthalmicus?

    <p>Preservative-free artificial tears</p> Signup and view all the answers

    What is the most appropriate management for postherpetic neuralgia related to herpes zoster?

    <p>Oral gabapentin</p> Signup and view all the answers

    In cases of increased intraocular pressure (IOP) associated with uveitis, what is a recommended course of action?

    <p>Switch to a topical aqueous suppressant</p> Signup and view all the answers

    What is the recommended follow-up interval for patients with ocular involvement after an acute herpes zoster episode?

    <p>Every week for 1-7 days</p> Signup and view all the answers

    Which treatment is indicated for stromal keratitis in herpes zoster?

    <p>Topical steroids tapering over months</p> Signup and view all the answers

    Which medication is often used for the management of uveitis in herpes zoster?

    <p>Prednisolone acetate</p> Signup and view all the answers

    What should be done if corneal ulceration occurs in neurotrophic keratitis?

    <p>Perform cultures to rule out bacterial infection</p> Signup and view all the answers

    Which of the following is a recommended initial treatment for conjunctivitis in the context of herpes zoster ophthalmicus?

    <p>Cool compresses</p> Signup and view all the answers

    Study Notes

    Entropion

    • Inward turning of the eyelid towards the globe.

    Trichiasis

    • Resultant trichiasis occurs when eyelashes turned inward and rub against the cornea, secondary to entropion of the upper and lower lids.

    Schirmer 1 Test

    • A measurement below 10 mm in 5 minutes is considered abnormal.

    Concretions

    • Small, chalky, white/yellow inferior sub-conjunctival palpebral deposits.
    • Often seen in elderly patients or those with chronic meibomian gland dysfunction.

    Distichiasis

    • A condition where eyelashes grow inward toward the globe from a position posterior to the normal row of lashes.
    • Typically, these lashes emanate from the meibomian gland orifices.
    • May be congenital or acquired secondary to chronic eyelid inflammatory conditions, surgery, or when an eyelid tumor is present.

    Trichiasis

    • Occurs when eyelashes originating from a normal position grow inward toward the globe.
    • No entropion of the eyelid margin is present.
    • Can occur after eyelid trauma, surgery, chronic blepharoconjunctivitis, cicatricial pemphigoid, trachoma, or may be idiopathic.

    Madarosis

    • A loss of lashes, usually due to a congenital condition or an infectious condition.
    • Trichotillomania occurs secondary to a compulsive urge to pull out one's own hair and/or eyelashes.

    Meibomian Gland Dysfunction (MGD)

    • Frothy tear film associated with MGD, also known as posterior blepharitis.
    • Caused by a dysfunction of the sebaceous glands.

    Symblepharon

    • A partial or complete adhesion between the palpebral conjunctiva of the eyelid to the bulbar conjunctiva of the globe.

    Phthriasis (Crab Lice)

    • Measures about 2mm long with a broad, flat body.
    • Typically observed on slit lamp exam clinging to the base of the eyelash or buried within the eyelid margin.

    Herpes Zoster Ophthalmicus

    • Ocular involvement may include:
      • Conjunctivitis: treated with cool compresses and erythromycin or broad-spectrum antibiotic.
      • Corneal pseudodendrites or SPK: lubrication with preservative-free artificial tears and ointment.
      • Stromal keratitis: topical steroids starting at QID and slowly tapering over months.
      • Uveitis: topical steroid and cycloplegic.
      • Neurotrophic keratitis: treated with erythromycin ointment and cultures to rule-out bacterial infection.
      • Retinitis/choroiditis/optic neuritis/cranial nerve palsies: IV acyclovir and prednisolone.
      • Increased IOP: may be steroid response or secondary to inflammation, treated with topical aqueous suppressants.
      • Postherpetic neuralgia: treated with amitriptyline, capsaicin, or oral gabapentin.

    Follow-Up

    • Patients with ocular involvement: examined every 1-7 days, depending on the severity of the presentation.
    • Patients without ocular involvement: followed every 1-4 weeks.
    • After the acute episode resolves, checked every 3-6 months.

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    Description

    This quiz explores the condition known as entropion, where the eyelid turns inward towards the eyeball. Participants will learn about its causes, symptoms, and potential treatments. Enhance your understanding of this ophthalmic issue.

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