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Questions and Answers

What is the primary condition associated with inflamed eyelid glands that can lead to infections?

Blepharitis is the primary condition associated with inflamed eyelid glands that can lead to infections.

Identify the condition characterized by the loss of skin pigmentation, often affecting areas like the face and hands.

Vitiligo is characterized by the loss of skin pigmentation.

Define hypopyon and explain its significance in ocular health.

Hypopyon is the presence of white blood cells in the anterior chamber of the eye and indicates inflammation or infection.

What is the difference between hyphema and hypopyon?

<p>Hyphema is the presence of red blood cells in the anterior chamber, whereas hypopyon is the accumulation of white blood cells.</p> Signup and view all the answers

What is a common cause of elevated venous pressure in relation to eye health?

<p>Common causes of elevated venous pressure include conditions such as venous thrombosis or congestive heart failure.</p> Signup and view all the answers

What condition can result from the blockage of eyelid glands?

<p>Chalazion can result from the blockage of eyelid glands.</p> Signup and view all the answers

What is the significance of elevated venous pressure in relation to eye health?

<p>Elevated venous pressure can lead to ocular conditions such as hyphema and increased risk of retinal issues.</p> Signup and view all the answers

Describe the role of antibiotics in treating eyelid infections.

<p>Antibiotics are used to treat infections when eyelid glands are involved, helping to resolve the inflammation.</p> Signup and view all the answers

What are hypopyon and hyphema, and how do they differ?

<p>Hypopyon is the presence of white blood cells in the anterior chamber, while hyphema is the presence of red blood cells.</p> Signup and view all the answers

What condition is characterized by loss of skin pigmentation, particularly on the face and hands?

<p>Vitiligo is characterized by the loss of skin pigmentation.</p> Signup and view all the answers

What are two common causes of conjunctival irritation that can lead to red eye?

<p>Allergies and chemicals are two common causes of conjunctival irritation.</p> Signup and view all the answers

Name a diagnostic procedure that helps assess the sharpness of vision in patients with red eye.

<p>A visual acuity test helps assess the sharpness of vision.</p> Signup and view all the answers

What is one effective method for managing blepharitis?

<p>Regular hygiene practices, such as warm compresses and eyelid scrubs, are effective for managing blepharitis.</p> Signup and view all the answers

What type of antibiotic is commonly used for treating dacrocystitis?

<p>Broad-spectrum oral antibiotics, such as cephalexin, are commonly used for treating dacrocystitis.</p> Signup and view all the answers

What symptoms are associated with uveitis, an ocular inflammation?

<p>Symptoms of uveitis include pain, photophobia, and red eye.</p> Signup and view all the answers

Which diagnostic procedure can detect corneal abrasions or ulcers?

<p>Fluorescein staining can detect corneal abrasions or ulcers.</p> Signup and view all the answers

Describe one form of treatment for chronic dacrocystitis.

<p>Dacryocystorhinostomy (DCR) is a surgical intervention used for chronic dacrocystitis.</p> Signup and view all the answers

What is the role of topical corticosteroids in managing ocular inflammation?

<p>Topical corticosteroids are used to reduce inflammation in conditions like scleritis and uveitis.</p> Signup and view all the answers

What are the primary symptoms of viral conjunctivitis?

<p>Symptoms include watery discharge, redness, and itching or discomfort in the eye.</p> Signup and view all the answers

How can allergic conjunctivitis typically be managed?

<p>Management includes taking antihistamines, avoiding allergens, and using cool compresses to relieve symptoms.</p> Signup and view all the answers

What type of discharge is associated with bacterial conjunctivitis?

<p>Bacterial conjunctivitis is characterized by a thick, yellow or green pus-like discharge.</p> Signup and view all the answers

What is a common cause of chlamydial conjunctivitis?

<p>Chlamydial conjunctivitis is commonly caused by the bacterium Chlamydia trachomatis.</p> Signup and view all the answers

What factors contribute to the development of ophthalmia neonatorum in newborns?

<p>Ophthalmia neonatorum is often caused by bacteria such as Neisseria gonorrhoeae or Chlamydia trachomatis.</p> Signup and view all the answers

What are the typical symptoms of allergic conjunctivitis?

<p>Typical symptoms include itchy, red, and watery eyes, as well as swelling of the conjunctiva.</p> Signup and view all the answers

What is the standard treatment for bacterial conjunctivitis?

<p>The standard treatment involves the use of antibiotic eye drops or ointments.</p> Signup and view all the answers

How is viral conjunctivitis primarily transmitted?

<p>Viral conjunctivitis is primarily transmitted through direct contact or contaminated surfaces.</p> Signup and view all the answers

What is a pterygium, and what are its common causes?

<p>A pterygium is a triangular growth of fibrovascular tissue on the conjunctiva, often caused by UV exposure, dry environments, and chronic irritation.</p> Signup and view all the answers

How can pingueculum be distinguished from pterygium?

<p>A pingueculum is a yellowish, raised growth usually found on the nasal side of the conjunctiva and is generally asymptomatic, unlike a pterygium which can obstruct vision.</p> Signup and view all the answers

What characterizes a subconjunctival hemorrhage, and how is it typically treated?

<p>A subconjunctival hemorrhage is characterized by a bright red patch on the white of the eye resulting from bleeding between the conjunctiva and sclera, usually self-limiting without treatment.</p> Signup and view all the answers

What are the main symptoms of scleritis, and what can cause this condition?

<p>Scleritis is characterized by severe pain, redness, and vision changes, often caused by autoimmune diseases, infections, or idiopathic factors.</p> Signup and view all the answers

Describe the symptoms of episcleritis and how it can be treated.

<p>Episcleritis generally presents with mild pain, discomfort, localized redness, and swelling, and it usually resolves on its own but can be treated with NSAIDs or topical corticosteroids if persistent.</p> Signup and view all the answers

What is the typical course of treatment for a symptomatic pterygium?

<p>A symptomatic pterygium, especially if large, is typically treated with surgical removal.</p> Signup and view all the answers

What risk factors are associated with the development of pingueculum?

<p>Risk factors for pingueculum include aging and prolonged exposure to UV light.</p> Signup and view all the answers

How can one differentiate between scleritis and episcleritis?

<p>Scleritis is associated with severe pain and vision changes, while episcleritis typically presents with mild pain and is usually benign.</p> Signup and view all the answers

What are the common causes of keratitis in contact lens wearers?

<p>Bacterial, viral, fungal, and protozoan infections can cause keratitis in contact lens wearers. Acanthamoeba is particularly concerning for those using contact lenses.</p> Signup and view all the answers

Explain how anterior uveitis can affect the pupil's appearance.

<p>Anterior uveitis can lead to posterior synechiae, making the pupil appear irregular. This is due to adhesions forming between the lens and the iris.</p> Signup and view all the answers

What is the primary symptom of severe uveitis that affects patients' quality of life?

<p>Photophobia is a primary symptom of severe uveitis that can drastically affect patients' daily activities. It may be accompanied by ocular pain and blurred vision.</p> Signup and view all the answers

Identify the series of symptoms that may indicate the presence of a corneal ulcer.

<p>Symptoms can include ocular pain, blurred vision, and redness of the eye leading to discomfort. Photophobia may also be present.</p> Signup and view all the answers

Describe the relationship between keratitis and inflammation of the eye.

<p>Keratitis is an inflammation of the cornea, often resulting from infections that can cause redness, pain, and blurred vision. It signifies an underlying ocular pathology.</p> Signup and view all the answers

What steroid therapy strategy is commonly used to manage anterior uveitis?

<p>Topical corticosteroids are commonly used to suppress inflammation and relieve symptoms in anterior uveitis. They aim to prevent damage to ocular structures.</p> Signup and view all the answers

What is a potential serious complication of untreated anterior necrotizing scleritis?

<p>Untreated anterior necrotizing scleritis can result in severe visual morbidity. It may lead to significant complications including glaucoma or even vision loss.</p> Signup and view all the answers

How can hypopyon serve as an indicator in the assessment of uveitis?

<p>Hypopyon, or the presence of white blood cells in the anterior chamber, indicates active inflammation, commonly seen in uveitis. It reflects the severity of ocular inflammatory processes.</p> Signup and view all the answers

What is a potential complication of blepharitis that affects the cornea?

<p>Bacterial or marginal keratitis can occur as a complication of blepharitis.</p> Signup and view all the answers

What are the classic signs of corneal involvement in blepharitis?

<p>Signs include inferior corneal punctate epithelial erosions and mild papillary conjunctivitis.</p> Signup and view all the answers

How does meibomian gland dysfunction relate to keratitis?

<p>Meibomian gland dysfunction can lead to abnormal tear lipids, contributing to instability and inflammation of the cornea.</p> Signup and view all the answers

What inflammatory condition can occur in the anterior segment of the eye and may involve the ciliary body?

<p>Uveitis is noted for inflammation of the anterior segment, including the iris and ciliary body.</p> Signup and view all the answers

What are the possible causes of recurrent epithelial erosion associated with blepharitis?

<p>Recurrent epithelial erosion may be caused by inflammation from blepharitis leading to corneal damage.</p> Signup and view all the answers

In cases of severe inflammation in uveitis, what symptom may predominantly affect pupil response?

<p>The pupil may be fixed and mid-dilated due to acute inflammation.</p> Signup and view all the answers

What is a distinguishing feature of keratitis related to infection from blepharitis?

<p>Keratitis commonly presents as painful red eyes accompanied by blurred vision.</p> Signup and view all the answers

What role do bacteria like Staphylococcus aureus play in affecting eyelid and corneal health?

<p>Bacteria such as Staphylococcus aureus contribute to blepharitis, leading to inflammation that can compromise corneal integrity.</p> Signup and view all the answers

What distinguishes scleritis from episcleritis in terms of vasculature response to 2.5% phenylephrine drops?

<p>Scleritis does not show vasculature constriction in response to 2.5% phenylephrine drops, while episcleritis does.</p> Signup and view all the answers

What is a potential serious complication of untreated scleritis?

<p>Untreated scleritis can lead to vision loss or scleral perforation.</p> Signup and view all the answers

Describe the typical pain experience of a patient with scleritis.

<p>Scleritis presents as aching, insidious pain that often wakes patients in the early morning and improves later in the day.</p> Signup and view all the answers

What common ocular condition can present with a bright maroon red area in fresh hemorrhage?

<p>Subconjunctival hemorrhage typically appears as a bright maroon red area.</p> Signup and view all the answers

How does the treatment approach differ between episcleritis and scleritis?

<p>Episcleritis may be treated with cool artificial tears or weak topical steroids, while scleritis often requires more aggressive treatment options.</p> Signup and view all the answers

What is the characteristic color and texture of nodules found in nodular scleritis?

<p>Nodules in nodular scleritis are typically deeper in blue-red color and immobile.</p> Signup and view all the answers

What symptom often accompanies uveitis that affects measurement of visual acuity?

<p>Uveitis can lead to pain and photophobia, which can significantly affect visual acuity measurements.</p> Signup and view all the answers

In uveitis, what is the significance of the appearance of hypopyon?

<p>Hypopyon indicates severe intraocular inflammation and can aid in diagnosing uveitis.</p> Signup and view all the answers

Study Notes

Inflammation of the eyelid

  • Oculoglandular syndrome is also known blepharitis
  • Infection of the meibomian glands produces blocked sebaceous glands 
  • Can be bacterial or viral in origin
  • Infection of the glands can cause chalazia 
  • Infection of the glands can cause sty
  • The infection of the glands can cause inflammation and swelling

Signs and Symptoms

  • Infection can cause redness and edema 
  • The eyelids can also feel itchy
  • Can also get foreign body sensation
  • Can lead to excess tears
  • Can be related to conjunctivitis
  • Can be associated with dry eye

Treatment

  • Warm compress can help
  • Cleaning the eyelids regularly can help
  • Artificial tears and lubricants can help
  •  Steroid drops or ointment can help
  •  Antibiotics are effective 
  •  Oral antibiotics can be given if the infection is widespread
  •  Surgery is needed for chalazion if it does not improve

Inflammation of the cornea

  • This condition is called keratitis 
  •  It can be caused by infection and inflammation
  • It can cause pain
  •  It can also cause photophobia
  • It can cause blurred vision 

Treatment

  •  Depends on the cause
  •  Antibiotics may be necessary 
  •  Steroid drops may be necessary 
  •  Surgery may be required, depending on the cause

Internal inflammation of the eye

  •  uveitis is any inflammation of the uvea that can include the iris, ciliary body, and choroid 
  •  Can cause pain and blurred vision
  •  Can be caused by infection, injury, or autoimmune disorders
  •  Treatment involves steroids and antibiotics
  •  Surgery, in some cases, may be required.

Acne-Prone Blepharitis

  • Blepharitis is an inflammation of the eyelids, often due to blocked oil glands.
  • The condition can be associated with acne.

Preseptal Cellulitis

  • This is an infection of tissues around the eye, but not the eye itself.
  • Symptoms may include redness, swelling, and pain in the eyelid area.
  • Treatment typically involves antibiotics.

Vitiligo

  • This autoimmune disorder causes loss of skin pigment, resulting in patches of lighter skin.

Polio

  • A viral infection that can cause paralysis.
  • Vaccines are available to prevent polio.

Tensor Fasciae Latae

  • A muscle in the thigh that helps with hip extension and hip abduction.

Eyelid Inflammation

  • Inflammation of the eyelids can be caused by infection, allergies, or irritation.
  • Symptoms may include redness, swelling, itching, and discharge.

Corneal Inflammation

  • Inflammation of the cornea, the clear outer layer of the eye.
  • Symptoms may include pain, blurred vision, redness, and sensitivity to light.

Uveitis

  • Inflammation of the uvea, the middle layer of the eye.
  • Symptoms may include pain, blurred vision, and sensitivity to light.

Hypopyon

  • White blood cells in the anterior chamber of the eye, a sign of inflammation.

Hyphema

  • Red blood cells in the anterior chamber of the eye, a sign of bleeding.

Medication Notes

  • Phenylephrine is a vasoconstrictor that can be used in eye drops to reduce redness and swelling.
  • Trabeton is a medication used to treat glaucoma, by reducing intraocular pressure.
  • Antibiotics may be used to treat infections, given by injection (IV) or orally.

Other Notes

  • "Beefy" appearance of the eye may be a sign of inflammation.
  • Wateriness of the eye can be a sign of irritation or infection.
  • Elevated venous pressure - Possible cause for inflammation around the eye.
  • Blocked oil glands of the eyelids can contribute to blepharitis.
  • Information regarding specific conditions and treatments can be found from reliable sources.

Causes of Red Eye

  • Red eye can be triggered by irritation, infections, or underlying systemic conditions.
  • Common causes include conjunctivitis (viral or bacterial), allergies, eye irritants, and subconjunctival hemorrhage.
  • Other causes include corneal conditions, such as ulcers, and eye pressure changes, like angle-closure glaucoma.
  • Systemic conditions, like hypertension or autoimmune disorders, can also manifest as red eye.

Diagnosing Red Eye

  • A thorough medical history, including symptom duration and severity, is a crucial part of diagnosis.
  • Visual acuity tests assess vision sharpness.
  • Slit-lamp examination offers a detailed view of the conjunctiva, cornea, and anterior chamber.
  • Fluorescein staining helps detect corneal abrasions or ulcers.
  • Intraocular pressure measurement is essential to rule out glaucoma.
  • Cultures and sensitivity tests, if indicated, help identify and treat infectious causes.

Managing Blepharitis

  • Maintaining excellent eyelid hygiene is crucial, including warm compresses and gentle scrubs.
  • Topical antibiotics like bacitracin or erythromycin ointments are used for bacterial infections.
  • Oral antibiotics, such as doxycycline, are prescribed in severe or chronic cases.
  • Steroid drops help manage chronic inflammation with significant symptoms.
  • Regular eyelid hygiene is essential for preventing recurrent blepharitis.

Treating Dacrocystitis

  • Antibiotic therapy with broad-spectrum oral medications (cephalexin) is common.
  • Warm compresses aid in symptom relief and promote drainage.
  • Surgical intervention, known as dacryocystorhinostomy (DCR), may be required for chronic cases or abscess formation.
  • Lacrimal sac massage aids in drainage for some individuals.

Ocular Inflammation

  • Uveitis, inflammation of the uvea, presents with pain, photophobia, and red eye.
  • Scleritis, inflammation of the sclera, causes severe pain and potential vision loss.
  • Management typically includes topical corticosteroids to reduce inflammation.
  • Systemic therapy, involving oral steroids or immunosuppressants, is used for severe cases.
  • Referrals to specialists are necessary for underlying systemic conditions, such as autoimmune diseases.
  • Regular follow-up care is essential to monitor for complications and progression of inflammation.

Conjunctivitis

  • Inflammation of the conjunctiva, the transparent membrane covering the white part of the eye and inside the eyelids.
  • Commonly known as "pink eye".

Viral Conjunctivitis

  • Typically caused by adenoviruses, often following a respiratory infection.
  • Characterized by watery discharge, redness in the eye, itching or discomfort, affecting one or both eyes.
  • Highly contagious, spreading through direct contact or contaminated surfaces.
  • No specific antiviral treatment, supportive care includes warm compresses and artificial tears.

Allergic Conjunctivitis

  • Triggered by allergens such as pollen, dust mites, pet dander, or mold
  • Symptoms include itchy, red, watery eyes, swelling of the conjunctiva, typically affecting both eyes.
  • Managed through antihistamines (oral or eye drops) and avoidance of allergens, cool compresses can provide relief.

Bacterial Conjunctivitis

  • Caused by various bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.
  • Presents with thick, yellow or green pus-like discharge, redness and swelling, crusting of eyelids, especially upon waking.
  • Can be contagious, often spread via direct contact.
  • Treated with antibiotic eye drops or ointments.

Chlamydial Conjunctivitis

  • Caused by infection with Chlamydia trachomatis, often linked to sexually transmitted infections.
  • Features redness, discharge (can be watery), and irritation, often chronic and requiring treatment to avoid complications.
  • Transmitted through sexual contact or from mother to baby during birth.
  • Treated with oral antibiotics, such as azithromycin or doxycycline.

Ophthalmia Neonatorum

  • Conjunctivitis in newborns, commonly caused by bacteria like Neisseria gonorrhoeae, Chlamydia trachomatis, or chemical irritants (like silver nitrate).
  • Exhibits red, swollen eyes, purulent discharge, occurring within the first month of life.
  • Requires prompt evaluation and treatment to prevent complications.
  • Antibiotic therapy is administered based on the identified causative organism.

Pterygium

  • Triangular growth of fibrovascular tissue on the conjunctiva
  • Occurs due to prolonged UV exposure, dry environments, and chronic irritation
  • Causes redness, irritation, and vision obstruction when it grows over the cornea
  • Small pterygia are usually monitored; surgical removal is done for larger or symptomatic pterygia

Pingueculum

  • Yellowish, raised growth on the conjunctiva, most commonly on the nasal side
  • Often associated with aging and UV exposure
  • Generally asymptomatic; can cause irritation or dryness
  • Artificial tears are used for irritation; surgical removal is performed in severe cases

Subconjunctival Hemorrhage

  • Leakage of blood between the conjunctiva and sclera
  • Caused by trauma, hypertension, bleeding disorders, and straining
  • Appears as a bright red patch on the white of the eye, usually painless
  • Usually self-limiting and resolves without treatment; recurrent or painful cases may require further evaluation

Scleritis

  • Inflammation of the sclera (white outer coating of the eyeball)
  • Caused by autoimmune diseases, infections, or unknown causes
  • Characterized by severe pain, redness, vision changes, and the possibility of nodules
  • Treated with NSAIDs or corticosteroids; immunosuppressive therapy may be necessary in some cases

Episcleritis

  • Inflammation of the episclera (tissue between the sclera and conjunctiva)
  • Characterized by mild pain, discomfort, localized redness, and swelling
  • Usually benign and comes in simple or nodular forms
  • Often resolves on its own; persistent cases may be treated with NSAIDs or topical corticosteroids

Keratitis

  • Inflammation of the cornea
  • Caused by infections (bacterial, viral, fungal), contact lens wear, and trauma
  • Symptoms include pain, redness, vision changes, tearing, and sensitivity to light
  • Treatment depends on the cause; antimicrobial drops are used for infections, along with supportive care

Corneal Ulcer

  • Open sore on the cornea, often due to infection
  • Symptoms include severe pain, redness, discharge, blurred vision, and light sensitivity
  • Risk factors include contact lens use, previous eye injury, and dry eyes
  • Requires urgent care; treated with antibacterial, antifungal, or antiviral eye drops depending on the cause

Uveitis

  • Inflammation of the uveal tract (iris, ciliary body, choroid)
  • Caused by autoimmune diseases, infections, trauma, or unknown causes
  • Symptoms include eye redness, pain, light sensitivity, blurred vision, and floaters
  • Treated with corticosteroids, dilating drops, and management of underlying causes

Scleritis

  • A painful inflammation of the sclera, the white part of the eye.
  • Often occurs in the upper temporal quadrant
  • More common in females, usually presents in the 5th decade
  • Deep, aching pain that may spread to the face, jaw, and temple
  • Pain is worse in the early morning hours and improves later in the day.
  • Responds poorly to common analgesics.

Types of Scleritis

  • Non-necrotizing scleritis:
    • Less severe, less destructive
    • May be diffuse (generalized redness) or nodular (single or multiple nodules)
  • Necrotizing scleritis:
    • More aggressive, can lead to severe visual morbidity
    • Pain is persistent and severe
    • Can be associated with rheumatoid arthritis, Wegener's granulomatosis, or surgically-induced

Treatment for Scleritis

  • Topical steroids: Relieve symptoms and oedema in non-necrotizing scleritis
  • Systemic NSAIDs: Relief of pain or regression of physical signs
  • Periocular steroid injections: When NSAIDs are ineffective
  • Systemic steroids: Used when NSAIDs are inappropriate or ineffective (necrotizing scleritis)
    • Prednisolone dose is 1.0–1.5 mg/kg/day
  • Immune modulators: Such as ciclosporin and tacrolimus
  • Cytotoxic agents: For example cyclophosphamide, azathioprine, mycophenolate mofetil, and methotrexate
    • Used when scleritis is not completely controlled with steroids alone
    • Used as a steroid-sparing measure in patients requiring long-term treatment
    • Used in patients with an underlying systemic vasculitis - can be life-saving

Oedema

  • May subside with treatment.
  • Slight grey/blue appearance may occur due to increased translucency of the sclera

Anterior Necrotizing Scleritis

  • Serious and aggressive form of scleritis
  • Later onset than other forms
  • May result in permanent visual loss

Anterior Uveitis

  • Inflammation of the front part of the uvea, the middle layer of the eye.
  • Can cause reduced visual acuity
  • Signs include:
    • Redness around the limbus (ciliary injection or ciliary flush)
    • Ocular pain
    • Photophobia
    • Blurred vision
  • Can lead to damage to the macula and optic nerve

Anterior Uveitis Treatment

  • Mainstay of treatment is steroid therapy
  • Aims are to:
    • Suppress inflammation in the eye
    • Relieve symptoms
    • Prevent damage to ocular structures

Pupil Shape, Size, and Reaction

  • In iritis, spasm of the iris sphincter muscles may cause the pupil to be smaller in the affected eye or distorted.
  • The pupil may be fixed and mid-dilated in acute angle closure glaucoma

Blepharitis

  • Inflammation of the eyelid and eyelid margin
  • Usually bilateral and symmetrical
  • Subdivided into anterior and posterior blepharitis

Anterior Blepharitis

  • Inflammation of the area surrounding the eyelash bases
  • Abnormal cell-mediated response to components of the S. aureus cell wall

Symptoms

  • Burning, grittiness, mild photophobia
  • Crusting and redness of the lid margins
  • Remissions and exacerbations

Signs

  • Hard scales and crusting around the base of lashes (collarettes) (staph)
  • Soft scales and greasy anterior lid margins with sticking together of lashes (seborrhoeic)

Posterior Blepharitis

  • Affects the meibomian glands within the eyelid
  • Meibomian gland dysfunction (MGD)
  • Results from bacterial enzymes from S. epidermidis, S. aureus, and Propionibacterium acnes

Symptoms

  • Burning, grittiness, mild photophobia
  • Crusting and redness of the lid margins
  • Remissions and exacerbations

Signs

  • Capping or plugging of the meibomian gland orifices
  • Dryness, oily, and froth on the lid margins
  • Hyperaemia and telangiectasis on the eyelid
  • Scarring and notching in long-standing cases
  • Mild papillary conjunctivitis
  • Inferior corneal punctate epithelial erosions

Blepharitis Complications

  • Tear film instability: Imbalance between aqueous and lipid components of the tear film, leading to increased evaporation.
  • Cutaneous: Acne rosacea (MGD) and Seborrhoeic dermatitis (seborrhoeic blepharitis) >90%
  • Lid: External hordeolum (stye) or internal hordeolum (painful, tender, red nodular masses near the eyelid margin), Chalazion formation
  • Cornea: Bacterial or marginal keratitis, recurrent epithelial erosion
  • Conjunctivae: Phlyctenulosis (rounded, elevated, gray or yellow, hyperemic, focal inflammatory nodules accompanied by a zone of engorged hyperemic vessels)
  • Contact lens intolerance
  • Inhibition of lid movement

Blepharitis Treatment

  • Lid hygiene: Gentle cleansing of the eyelid margins
  • Antibiotics: Topical sodium fusidic acid or chloramphenicol
  • Medical: Tear substitutes and topical steroids for inflammation
  • Sunglasses: To reduce ultraviolet exposure and decrease growth stimulus

Epicanthus

  • A fold of skin that covers the inner corner of the eye.
  • Can be a normal variant or a sign of a condition.

Subconjunctival Haemorrhage

  • Blood beneath the conjunctiva causing a bright maroon red appearance.
  • May be idiopathic or caused by:
    • Hypertension
    • Valsalva maneuver (coughing, constipation, heavy lifting)
    • Bleeding diathesis
    • Anticoagulants
    • Trauma
  • Haemorrhage without a posterior margin may be associated with an intracranial bleed.
  • Check BP and IOP.
  • If recurrent, request coagulation screen and FBC.
  • Treatment is usually not required as the haemorrhage will fade over 2 weeks.
  • Refer to a haematologist if a bleeding diathesis is detected or a general practitioner if hypertensive.

Episcleritis

  • Inflammation of the episclera, the thin layer of tissue between the sclera and conjunctiva.
  • Redness that can be sectoral, diffuse, or nodular
  • Interpalpebral distribution
  • Usually peaks within 12 hours and then gradually fades over a few days

Episcleritis Treatment

  • Cool artificial tears may be sufficient in some cases
  • A weak topical steroid q.i.d. for 1–2 weeks is usually sufficient

Differentiation from Episcleritis

  • Instillation of 2.5% phenylephrine drops will constrict the conjunctival and superficial episcleral vasculature (episcleritis) but not the deep plexus (scleritis).

Keratitis/Ulcer

  • Inflammation or ulceration of the cornea.
  • Can be caused by:
    • Infection (bacterial, viral, fungal, protozoal)
    • Mechanical or trauma (foreign body)
    • Chemical (alkali injuries are worse than acid)

Classification of Scleritis

  • Diffuse scleritis: Generalized oedema with vascular congestion and dilatation.
  • Nodular scleritis: Single or multiple nodules, usually developing in the interpalpebral region. These have a deeper blue-red colour than episcleral nodules and are immobile.

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Description

This quiz covers the conditions related to inflammation of the eyelid, including blepharitis and its causes, signs, symptoms, and treatments. It also touches upon keratitis and its implications. Test your knowledge on eye infections and their management!

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