Home > Information for doctors >Tutorials >Eyelid Problems

Francisco Machado 3/98

Chalzion(meibomian cyst)
-commonest lump in eyelid
-granuloma of lipid secretiong meibomian glands, as a result of a blocked duct and resultinginflammation
-pt c/o initially a hard painful lump, may susequently cause astigmatism
-Mx many settle with warm compresses and chloramphenicol eye ointment.
-if painful,large, persistent, visual disturbance refer ofr incision

Stye
-infection of lash follicle
-treatment hot compresses and chloramphenicol

Marginal cysts of sweat (clear contents) and lipid secreting glands (yellow contents)
-excise for cosmetic reasons

Papillomas
-viral
-remove if large, disfiguring or diagnosis in doubt

Xanthelasma

BCC
-lower eyelid
-referred urgently

Inflammatory diseases of eyelid

Blephritis
-chronic disease
-pt c/o persistent sore eyes, grittiness , sore eyelids
-may present with a stye/chalazion which are more common
-O/E inflam lid margins, crusts, inflamm conjunctiva, punctate staing of cornea
-ass with rosacea, eczema and psoriasis

Management
-Keep lids clean with warm water and cotton wool
-treat staph infection with a topical antibiotic, this may need to be done for several months
-replace tears
-treat seb gland dysfuction, e.g. in acne rosacea treat with oral oxytetracycline

Acute inflammation of eyelid

Causes

1. Chalazion or stye
2. spread from local spots-systemmic antibiotics
3. Acute dacryocystitis-local and systemmic antibiotics until infection resolves
4. Orbital cellulitis
- May cause blindness and can be life threatening
-usually spreads from sinuses

• PC Unilateral swollen eyelids thta may not be red

• The patient is unwell

• Tenderness over sinses

• Restriction of eye movements

Always keep this in mind esp in children and refer.

5. Allergy - weak topical steroid
6. HSV-vesicular rash +/- ocular corneal infection refer
7. HZV Shingles- ocular involvement may occur late so always cosider this and refer

Malpositions of eyelids

Main symptoms

1. irritation of eye by lashes rubbbing on it = entropion or trichiasis may cause corneal scarring.
2. Watering of the eye caused by malposition of the puctum = ectropion

Lacrimal system

Watery eye

Anatomy

Tears produced laterally and migarate medially

Causes

1. Excessive secretion rare but may occur in 'dry eyes ' in an attempt to over compensate
-Hx of intermittent irritation and then excessive watering
-treat dry eye
2.Malposition of punctum
3. Punctal stenosis
4. Blocage of lacrimal or nasolacrimal duct.
-e.g. infants

Dry eye

Common in elderly and some systemmic disorders, and some drugs e.g. diuretics
-chronic gritty sensation and occ corneal staining
Artificial tear drops, simple eye ointment nocte and treat ass blephritis

Francisco Machado 3/98

 

Top