PANCE Blueprint EENT (7%)

Lid disorders (PEARLS)

The NCCPA™ PANCE Eyes, Ears, Nose, and Throat Content Blueprint eye disorders ⇒ lid disorders

Blepharitis Eyelid changes: crusting, scaling, red-rimming of eyelid and eyelash flaking along with dry eyes and associated seborrhea and rosacea

TX: Warm compresses, irrigation, lid massage, and topical antibiotics for flare-ups

  • Daily lid wash with baby shampoo
Chalazion A chalazion is a sterile painless (non-infectious) granuloma of the internal meibomian sebaceous gland, painless "cold" lid nodule, versus hordeolum, which is a painful infectious "hot" nodule

  • Chalazion occur more commonly in the upper eyelid because of the presence of more sebaceous glands
  • Unlike a hordeolum (stye), a chalazion tends to have a more gradual onset, is less painful, and affects the middle part of the eyelid

TX: Warm compresses, and eyelid hygiene

  • Injection of corticosteroid or incision + curettage may be necessary for a large chalazion that is affecting vision
Ectropion Ectropion (eversion of the eyelid) occurs when the eyelid turns outward exposing the palpebral conjunctiva, conjunctiva will appear red from air exposure and inflammation

TX: Tear supplements and ocular lubricants at night

  • Definitive treatment is surgery
Entropion Entropion (inversion of an eyelid) occurs when the eyelid turns inward. It is most commonly caused by age-related tissue relaxation, surgical correction is definitive
TX: Tear supplements and ocular lubricants at night

  • Definitive treatment is surgery
Hordeolum (stye) (ReelDx) A painful red infection in a gland at the margin of the eyelid

  • Painful, warm (hot), swollen red lump on the eyelid (different from a chalazion which is painless)
  • Think “H” for Hot = Hordeolum. Most common organism S.  aureus

TX: Warm compress and topical antibiotics

  • A hordeolum that does not respond to hot compresses can be incised with a sharp, fine-tipped blade
  • Systemic antibiotics (eg, dicloxacillin or erythromycin 250 mg PO QID) are indicated when cellulitis accompanies a hordeolum
Dacryoadenitis (Prev Lesson)
(Next Lesson) Blepharitis (Lecture)
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