Podcast
Questions and Answers
Which characteristic is most indicative of pre-septal cellulitis?
Which characteristic is most indicative of pre-septal cellulitis?
Which of the following is the most common location for pre-septal cellulitis in children?
Which of the following is the most common location for pre-septal cellulitis in children?
What is the primary cellular origin point of basal cell carcinoma (BCC)?
What is the primary cellular origin point of basal cell carcinoma (BCC)?
Which of these is a primary characteristic of the ulcerative type of basal cell carcinoma?
Which of these is a primary characteristic of the ulcerative type of basal cell carcinoma?
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What physical sign of an eyelid lesion is most concerning and warrants prompt referral?
What physical sign of an eyelid lesion is most concerning and warrants prompt referral?
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What characteristic distinguishes squamous cell carcinoma (SCC) from basal cell carcinoma (BCC) of the eyelid?
What characteristic distinguishes squamous cell carcinoma (SCC) from basal cell carcinoma (BCC) of the eyelid?
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Which of the following statements about cysts of Moll is correct?
Which of the following statements about cysts of Moll is correct?
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Which condition is most commonly associated with thyroid eye disease?
Which condition is most commonly associated with thyroid eye disease?
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Study Notes
Pre-septal Cellulitis
- Common infection of eyelid and periorbital soft tissues
- Primarily affects children (80% under 10, mostly under 5)
- Symptoms may include fever, tiredness, and irritability
- Septal barrier prevents infection from spreading to the orbit
- Often preceded by upper respiratory tract infections (e.g., sinusitis)
- Causative organisms include Staphylococcus aureus, Staphylococcus epidermidis, streptococci, and anaerobes
- Symptoms include acute pain, swollen eyelid, redness, blurred vision, conjunctivitis, and tearing.
Bacterial Orbital Cellulitis
- Infection of tissues posterior to the septum
- Usually caused by spread from an adjacent sinus (most common is ethmoid sinus)
- Can also spread from dacrocystitis (tear duct infection) or trauma/surgery
- Causative organisms include Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, and Beta-hemolytic streptococci
- Symptoms include pain with eye movement, conjunctival swelling, proptosis (bulging eye), ophthalmoplegia (eye muscle weakness), restricted eye movements, decreased vision (due to optic nerve compression), and systemic symptoms like fever and malaise.
Management
- Confirmation of diagnosis crucial
- Treatment of underlying conditions
- Aggressive systemic antibiotics commonly used
- In younger children/severe cases, IV antibiotics may be necessary
- Failure to respond to antibiotics requires further investigation (e.g., CT scan of the orbit and sinuses, pus drainage)
Tumors - Basal Cell Carcinoma
- Accounts for 80-90% of eyelid cancers
- Slow-growing and destructive
- Locally invasive
- Classic presentation is a non-healing ulcer with pearly white borders
- Stems from the basal layer of the skin
- Most common in light-skinned individuals with high UV exposure
- Increased incidence with age; peaks in the 70s
- Often presents as a nodular, ulcerative, or morpheic lesion
- Requires surgical removal and potentially skin grafting if large
Tumors - Squamous Cell Carcinoma
- Rare compared to basal cell carcinoma
- More aggressive than basal cell carcinoma
- Second most common eyelid malignancy (about 5%)
- Usually in the elderly
- Often linked to chronic sun exposure and pre-cancerous lesions (actinic keratosis, Bowen's disease)
- Higher risk for immunocompromised individuals
- Surgical removal is common management
Benign Eyelid Lesions
- Cysts from eyelid glands (e.g., Meibomian, Zeis)
- Molloscum contagiosum: contagious benign skin lesions, dome-shaped, waxy lesions, spread through direct contact
- Treatment is often cosmetic
Thyroid Eye Disease
- Primarily affects women in their 40s to 60s
- Associated with Graves' disease (autoimmune condition)
- Symptoms may involve systemic issues (tremor, weight loss, etc.) and prominent eye changes (proptosis, lid retraction, irritation due to corneal dryness etc.)
- Severe cases involve optic nerve compression, leading to vision loss.
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Description
This quiz explores the characteristics and differences between preseptal and orbital cellulitis, two infections impacting the eye area. It covers common symptoms, causative organisms, and typical age groups affected. Ideal for medical students and healthcare professionals seeking to enhance their understanding of ocular infections.
