Opthalmology

Chalazion :chronic
lipogranulomatus
reaction
Blockage of Meibomian gland
orifices .
Indication of surgery:
1.effect vison
2.persist for long time
3.non response to medical
Treatment
4.cosmotic
complication: stigmatism
method of intervention :
1.intralesional steroid
2.surgical intervention ( incision
and curettage
Incision and curettage
Clip lid lip
local anesthesia and
surrounding the mass then
clos the clip then incision and
curette and cleaning it’s
contain.
Closure for 6 hr .
Give him antibiotic
xanthalasma
Lipid deposition
(microphage ingested
lipid)
management:
fasting lipid profile
if hyper lipedema give
lipid lowering agent .
Surgical removal for
cosmetic
Pedunculated mass
(wart)
Caused by human
papilloma virus .
Treated by simple
excision .
Oculodermal nevus
Keep under
observation till it
become enlarged so
give biopsy
if it malignant
excision and grafting
Capillary
hemangioma
1.Pressure effect (mechanical
ptosis)
2.blured vision
3.lazy eye ( different in vision
between two eye)
4.bleeding ,pain, necrosis, infection.
5.stigmatisim
treatment:
observation till 3 y.
local and systemic beta blocker
intralesional and systemic steroid
Squamous cell
carcinoma
history of recurrent
chalazion.
Management : excional
biopsy and
histopathology. Plastic
surgery .
Basal cell carcinoma.
DDx: sty. Conjunctivitis
treatment : exicional with safe margin
Basal cell
carcinoma excision
and skin graft in
the lower left eye
lid
Trichiasis
Causes: long standing
blepharitis.
Congenital. Trachoma.
Scaring. Entropian .
Treatment : eyelash
ablation
laser ablation. Electrolysis
.cryosurgery
Angioedema
Swelling and redness of
eye lid
type 1 hypersensitivity
treatment : antihistamine
Steroid
intralesional adrenaline
Left : poliosis :whitish
discoloration of eyelash.
Causes :long standing
blepharitis, autoimmune disease
Right : madarosis :decrease in
number or complete loss of eye
lash
causes: chronic blepharitis
,burn, radiation, alopecia,
psoriasis.
contact dermatitis
Delay type
hypersensitivity
Causes : exposure to
chemical agent, specially
antiglycomic drug.
Treatment: remove the
underlying cause.
DDx: bilateral
dermatitis ,infection.
Stye (external
hordeolum )
Staphylococcal Infection
in lash follicle and it’s
gland of zies
treatment: hot
compresses, topical
antibiotic, lash epilation
systemic antibiotic.
Mulescum
contgiosum(multiple
elevated skin lesion with
thick consistency )
Caused by
molluscipoxvirus
(dsDNA)
treatment: deep removal
by excision to prevent
recurrence.
Herpes simplex
watery elevated skin
lesion with thin wall .
In immune
compromised child
caused by HSV1
Ptosis
The severity determine by
the distance between
upper lid margin and
light reflex.
Mild: 2mm of droop
moderate :3 mm of droop
severe: 4 mm of droop
and more
Herpes zoster
Unilateral and not crossed
the midline
related to one dermatome
DDx: infection cellulitis
complication: keratitis ,
conjunctivitis
treatment: antiviral acyclovir
Chronic blepharitis
Detailed in
lecture
Apparent regeneration of
third nerve
(2function of third nerve)
Treatment : surgical
resection of LPS
muscle
Ectropian
Detailed in lecture
Diamond excision
Surgical
intervention of
ectropian
Entropian
Detailed in lecture
epiphora
Excessive tear
detected by Green
Fluricine stain
Diagnostic needling
test
By injection normal
saline and ask the patient
if reach to the throat or
not to detect any
obstruction in lacrimal
system
 DDx of epiphora
1.Conginetal NLDO.
2.punctum atresia.
Usually unilateral this 2 causes
must excluded firstly
3.congenital glycoma
4.chronic conjunctivitis
5.keratitis
the later 3 causes is bilateral.
Tx: observation till 1y.NLD
massage. and fallow up.
After 1y if not relief do needling
and dilation under GA.
Needling and dilation
Lacrocystitis: staph or strept infection of nasolacrimal sac
TX: analgesia, antibiotic.
If abscess formation it must be drain.
Hyphemia :blood collection
in the anterior chamber .
complication:1.glycoma 2.
corneal blood staining.
Tx: bed rest, topical steroid,
antiglycoma , antibiotic cover,
observation , atropine for
pupil dilation and stope
bleeding .
Fallow up 5-7 day if not
recovery do aspiration for the
clotting .
Papillary reaction of upper
eye lid
causes : chronic blepharitis
allergic conjunctivitis
bacterial conjunctivitis
contact lens related problems.