Additional Dry Eye Associations

lid margin keratinization

pathological process in which the normally nonkeratinized epithelium of the posterior lid margin becomes keratinized

Stevens-Johnson Syndrome

severe mucocutaneous immune rxn often triggered by medication/infection categorized by widespread epithelial cell death

mucous membrane graft

surgical procedure where keratinized lid margin & adjacent scarred tarsal conjunctival epithelium is replaced w/ normal tissue derived from oral mucosa

cutaneous rosacea

chronic, relapsing inflammatory skin disorder of the central face w/ persistent/recurrent facial erythema & flushing

erythematotelangiectatic

persistent central facial erythema w/ flushing & telangiectasia

papulopustular

persistent erythema w/ inflammatory papules & pustules

phymatous

tissue thickening & sebaceous-gland hyperplasia

ocular rosacea

chronic inflammatory condition impacting eyes as well as surrounding periorbital skin (bilateral & symmetric)

hordeolum

acute bacterial infection of sebaceous eyelid glan

internal hordeolum

• most common

• involvement of meibomian gland

• appears erythematosus lesion

• must document rubor, calor, tumor, dolar (pain), functio laesa (loss of function)

external hordeolum

• involvement of gland of Zeis & gland of Moll

• appears erythematosus pustular lesion

• must document rubor, calor, tumor, dolar (pain), functio laesa (loss of function)

hordeolum tx

erythromycin ointment (bacteriostatic)

chalazion

localized, chronic, sterile granulomatous infection caused by obstruction of meibomian glands w/ resultant retention of lipid-rich secretions w/in eyelid

chalazion signs on eyelid

• round, swollen lesion

  • erythema possible (mild)

• localized w/in tarsal plate

  • centered around meibomian gland

diagnostic considerations of chalazion

palpation of tarsal plate nodule will m.likely reveal lesion lacks warmth & tenderness and/or pain

preseptal cellulitis (periorbital cellulitis)

bacterial infection of eyelids localized anterior to orbital septum

orbital septum (palpebral fascia or septum orbitale)

strong circular sheet of dense connective tissue which runs from orbital rim to tarsal plates in the eyelids

key signs of preseptal cellulitis

• abscess

• exophthalmometry (no proptosis identified)

• palpation (discomfort per pt, warm to touch)

orbital cellulitis (postseptal cellulitis)

bacterial infection which extends posterior to the orbital septum

orbital septum (palpebral fascia or septum orbitale)

strong circular sheet of dense connective tissue which runs from orbital rim to tarsal plates in the eyelids

dacryocystitis

lacrimal sac infection/inflammation

lamina papyracea

“paper - thin “ bone plate which forms the lateral wall of labyrinth of the ethmoid

key signs of orbital cellulitis

• localized periorbital edem & erythema

• exophthalmometry (proptosis identified)

• palpation (tender per pt & warm to touch)

• will have pain & diplopia in EOMs

• + for RAPD