Blepharitis
- Inflammation of the eyelid margins
- Itchy, gritty, dry sensation
- Can be associated with dysfunction of the Meibomain glands which are responsible for secreting meibum (oil) onto the surface of the eye. Can lead to styes and chalazions
- Management if warm compress and gentle cleaning of the eyelid margin to remove debris
Stye
Hordeolum externum
- Infection of the sweat glands or the sebaceous glands at the base of the eyelashes (glands of Moll and glands of Zeis)
- Causes a tunder red lump along the eyelid that may contain pus
Hordeolum internum
- Infection of the Meibomian glands
- Deeper and more painful
- May point towards the eyeball underneath the eyelid
Management with hot compress and analgesia. Topical antibiotics (chloramphenicol) may be considered if its associated with Conjunctivitis or if symptoms persist.
Chalazion
- Occurs when a Meibomian gland becomes blocked and swells - Meibomian cyst
- Presents with swelling in the eyelid that is typically not tender
- Treatment is with a warm compress and gentle massage towards the leyelashes to encourage drainage.
- Surgical drainage only rarely required
Entropion
- When the eyelid turns inwards with the lashes pressed against the eye
- Causes pain and can result in corneal damage and ulceration
- Initial management is by taping the eyelid down to prevent it turning inwards - eye drops must be administered to prevent the eye from drying out
- Definitive management is surgical
- Same day ophthalmology referral is required if there is a risk to sight
Ectropion
- When the eyelid turns outwards exposing the inner aspect
- Usually affects the bottom lid
- Can result in exposure keratopathy (damage to cornea), if eyes are not adequately lubricated and protected
- Mild cases may not require treatment - same day referral if risk to sight
Trichiasis
- Inward growth of the eyelashes.
- Can results in corneal damage and ulceration
- Management is removal of the offending eyelashes
- Recurrent cases may required electrolysis, cryotherapy or laster treatment
- SDF if risk of eyesight
Periorbital cellulitis
- Eyelid and skin infection in front of the eye. It presents with a swollen, red, hot skin around the eye lid and eye
- Must be differentiated from Orbital cellulitis a sight and life-threatening emergency
- Patients are referred urgently to ophthalmology for assessment. CT can help distinguish
Orbital cellulitis
- Infection around the eyeball involving the tissues behind the orbital septum
- Pain with eye movement, reduced eye movements, vision changes, abnormal pupil reactions and proptosis
- Requires emergency admission under ophthalmology and IV antibiotics
- Surgical drainage may be needed if an abscess forms