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Eye Disorders

Blepharitis Blepharitis is characterized by inflammation of the eyelids There is anterior and posterior blepharitis Anterior is characterized by inflammation of the base of the eyelashes. Less common than posterior Posterior is characterized by inflammation of the inner portion of the eyelid, at the level of the meibomian glands.

Blepharitis Can cause colonization of staphylococcal organisms Can be associated with Rosacea and Seborrheic Dermatitis Typically patients will have red eyes, a gritty sensation, excessive tearing, eyes may burn, swollen erythematous eyelids, crusting, and photophobia. Lid hygiene is important for treatment

Blepharitis Warm compresses can be helpful Topical antibiotics such azithromycin, erythromycin, or bacitracin may be helpful in reducing bacterial load of the lashes Oral antibiotics such as tetracycline for severe cases of blepharitis

Blowout Fracture Blowout fractures of the eye are fracture of the floor of the orbit Typical mechanism is getting hit with a round object May causes entrapment of the inferior rectus muscle Ischemia may cause loss of the muscle function and result in edema or hemorrhage of the muscle

Blowout Fracture Enophthalmos (the eyeball receded into the orbit) may develop when the globe is displaced posteriorly Injury to the inferior orbital nerve may result from this causing sensory loss in that distribution

Cataract Leading cause of blindness in the world It is an opacity in the lens of the eye that can cause total or partial blindness Embryonic development and lifelong growth of the lens produce a complex layering of cells The lens does not shed its nonviable cells and this causes degenerative effects on its own cell structure leading some opacity problems

Cataract Risk factors for acquired cataracts are: age, smoking, alcohol, sunlight, metabolic syndrome, diabetes, statins, and long term use of high dose steroids No convincing evidence that vitamin supplementation decreases incidence Only treatment is surgical correction

Chalazion Chalazion is an inflammatory lesion that develops when the meibomian tear gland becomes obstructed May first present as eyelid swelling and erythema, then evolve to a nodular rubbery lesion Commonly seen in patients with blepharitis and rosacea Antibiotics are not indicated

Chalazion Frequent hot compresses are effective Most of the time not painful or tender Symptomatic patient scan be referred to ophthalmology for incision and curettage or steroid injection

Conjunctivitis Conjunctivitis is inflammation of the conjunctiva. Can be infectious or non infectious Conjunctiva is usually transparent and gets red when inflamed Infectious can be viral or bacterial Non infectious can be allergic or non allergic Bacterial typically caused by strep pneumonia, staphylococcus aureus, haemophilius influenzae, and moraxella catarrhalis

Conjunctivitis Can be caused by neisseria gonorrheae and chlamydia Viral is usually adenovirus Allergic conjunctivitis is caused by airborne allergens contacting the eye that cause mast cell degranulation Itching is the cardinal symptom for allergic conjunctivitis Can be non allergic from chronic dry eye Contact lens wearer need to throw away contacts and irrigation solution and case Bacterial conjunctivitis include erythromycin ointment or polytrim drops.

Conjunctivitis Can also use sulfacetamide, azithromycin drops or bacitracin ointment Ciloxin needed for contact lens wears in bacterial conjunctivitis because of pseudomonas prominence For allergic conjunctivitis can use OTC decongestants, antihistamines, and patanol. Students must receive topical therapy 24 hours before returning to school

Corneal Abrasion Usually result from trauma to the eye or from improper contact lens use Diagnosis is made with slit lamp exam and fluorescein dye exam Treatment consists of topical antibiotics (drops or ointment) and oral pain medication Most corneal abrasions heal within twenty-four hours after the accident

Corneal Abrasions Patients present with photophobia, pain and foreign body sensation If a foreign body is detected can be removed with irrigation or swab after instillation of topical anesthetic Superficial foreign bodies can be removed with a twenty five gauge needle or foreign body spud No patching of the eye