Chalazion vs hordeolum vs blepharitis
Terms in this set (22)
a sterile granulomatous inflammation/mass of a meibomian (oil-secreting) gland on the upper or lower eyelid
Blockage in a duct leading to the eyelid surface from the gland or obstruction of a meibomian gland results in inflammation, the formation of a hard mass, and/or infection—very rare (usually from Staphylococcus).
occurs at any age; occurs equally in men and in women
Signs/symptoms of chalazion
slow-developing, painless (KEY FINDING), hard mass with inflammation of the meibomian gland and possible involvement of the surrounding tissue.
Chalazion physical exam
with eversion of the eyelid reveals a red, elevated mass that may become quite large and press against the eye, causing nystagmus
visual exam (to R/O other problems), culture of drainage (if I & D is done), biopsy of recurrent chalazion to R/O malignancy
warm compresses to area-or can leave alone-no antibiotics usually used
When to follow up chalazion?
1 week; may take several weeks to months for complete resolution. Recurrences common
When to refer?
to ophthalmologist if visual change, pain or impairment to the eye; or if surgical removal needed.
Hordeolum (stye) Definition
A small, pus-filed abscess involving the hair follicle of the eyelid
Hordeolum (stye) Etiology
usually caused by staphylococcal infection; may be a secondary infection.
Hordeolum (stye) Epidemiology
occurs most commonly in children and adolescents; occurs equally in men and in women
Hordeolum (stye) contributing factors
Recurrent blepharitis, makeup, contact lens, poor eyelid hygiene, eye irritation from smoking
Hordeolum (stye) signs and symptoms
papule on lid margin, erythematous, tender to palpation,
Hordeolum (stye) Physical Exam
reveals the head of the stye on the outside of the lid or when the eyelid is everted, on the underside
Hordeolum (stye) Treatment
Warm, moist compresses to the eyes several times a day. Allow to open and drain spontaneously; do not squeeze. (Pain decreases when stye opens and drains). Can use baby shampoo for hygiene
Erythromycin ophthalmic ointment tid thinly applied to area with a cotton-tipped applicator till 2-3 days after resolution
Ofloxacin 0.3%, >1y, 1-2 gtt q2-4h x 2 d, then 1-2 QID x 5 days
Moxifloxacin (Vigamox)- >1y- 1 gtt TID x 7 day
gentamicin ophthalmic ointment if refractive to treatment
Hordeolum (stye) follow up, complications, when to refer
Complications: cellulitis of eyelid, repeated styes (if occurs, evaluate for DM)
Refer: if draining of abscess needed
inflammation involving the structures of the lid margin with redness, scaling and crusting.
May be staphyloccocal or seborrheic, allergy.
Tends to be chronic with acute flare-ups and is more common in fair-skinned people. Seen more with contact lens solution or contaminated make-up.
Blepharitis Signs and Symptoms
If staphylococcal, dry scales, lash loss, sometimes conjunctivitis; If seborrheic, greasy scales and less redness. Allergy-dry and flaky, usually itchy
Usually responds to lid hygiene measures and topical antibiotics
Can instruct patient to dilute Johnson's baby shampoo 50:50 with water and use a cotton ball to scrub the lids well with the eyes closed.
After rinsing with water, a hot compress is applied to the closed lids for 5-10 minutes, and then ophthalmic ointment is instilled in the inferior fornix.
---Erythromycin ointment 1cm ribbon up to 6x/d x 7-10d
The excess is rubbed into the eyelash base.
Do this 3-4 times/day
After improvement is obtained, the lids can be maintained by nightly lid hygiene and warm compresses.
If chronic may need oral erythromycin (rare in children)