www.ophthalclass.blogspot.com has the complete class and MCQs on lids and adnexa for undergraduate medical students. Class 1 in the series deals with the basic anatomy of the eyelid and the eyelid margin. A few of the congenital eyelid disorders are mentioned. Special emphasis is given to blepharitis – inflammation of the eyelid margin, its types, clinical features and management. Next, common causes of eyelid swellings including hordeolum or stye and chalazion are discussed. Finally a brief mention is made about disorders of the eyelashes – trichiasis, poliosis, madarosis and distichiasis.
17. Management of anterior blepharitis Lid hygiene Warm compresses Mechanical removal of crusts and scales by scrubbing Baby shampoo as scrubbing solution Application of antibiotic eye ointment (Staphylococcal) Anti-dandruff shampoo for scalp (Squamous)
19. Clinical features of posterior blepharitis Meibomian orifices Pouting, obstructed, oily globules Telangiectasia around orifices Digital pressure on lid margin Hyposecretion Hypersecretion – foamy, turbid or tooth paste like secretion
21. Management of posterior blepharitis Warm compresses Lid massage to express oily secretion Short term antibiotic – steroid eye ointment, ocular lubricants In severe cases and in acne rosacea – oral tetracycline / doxycycline for at least 6-8 weeks
22. Eyelid gland inflammations Acute inflammation (stye) Staphylococcal infection Glands of Zeiss / Moll (associated with hair follicles) – Hordeolumexternum Meibomian glands – Hordeoluminternum Acute, painful and tender nodular swellings of the lid
26. Hordeolum Management of hordeolum Mainstay of therapy – hot compreses If pus pointing present at eyelash base – remove eyelash If pus pointing at the skin or conjunctiva – drain pus If associated with blepharitis – treat blepharitis