Lid Diseases-I - Diseases of Lids Power point copy of...

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Diseases of Lids Power point copy of Lecture taken by Prof Sanjay Shrivastava For Junior Final Year students of Gandhi Medical College, Bhopal (M.P.)
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Anatomy of Lid
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Hordeolum Externum (Stye)
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Hordeolum Externum (Stye) Definition: Localized suppurative inflammation of gland of zeis at lid margin at ciliary follicle.
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Etiology Usually caused by staphylococcus aureus There is infection of hair follicle of eyelash. It may complicate Acne Vulgeris in young adults.
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Histopathology Purulent infection of follicle and its gland with cellulitis of surrounding connective tissue
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Clinical Picture Stye are frequently recurrent, appearing in crops. Recurrent lesion is particularly seen in cases of debility, focal infections and diabetics.
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Symptoms Severe pain which is sharp throbbing , feeling of fullness or heaviness and feeling of heat Tenderness (increase in pain on touching swelling/ affected area) Pain subsides on escape of pus
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Signs Starts usually as edema of the lids with chemosis Yellow pus point appears on the lid margin around the root of a lash at the most prominent part of the swelling
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Signs … contd Skin gives way and pus drains with sloughing Swelling subsides and cicatrix form Spread of infection to neighbouring lashes opposite lid margin and conjunctival sac Subsidence of inflammation may leave area of induration
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Hordeolum Externum
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Complications Cellulitis (particularly in cases of lesion at inner canthus) Orbital thrombophebitis (leading to cavernous sinus thrombosis and its complications)
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Treatment I. Systemic a. Antibiotic b. Anti-inflammatory analgesic c. Supportive d Treatment of associated systemic predisposing cause
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Treatment II. Local a. Hot fomentation b. Local broad spectrum antibiotic drop and ointment c. Evacuation of pus when pus points, sometimes epilation may be required before evacuation of pus (lid margin/ lesion should never be squeezed)
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Hordeolum Internum
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Hordeolum Internum Hordeolum Internum is a suppurative inflammation of meibomian gland. It may be due to secondary infection of meibomian gland or it may start to begin with as suppurative infection of meibomian gland. This condition is more symptomatic than stye, the gland is larger and is located in fibrous tarsal plate
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Symptoms Pain, which may be severe throbbing Swelling , which is away from lid margin Pus pointing either at the lid margin or on the palpabral conjunctiva
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Signs Swelling of affected lid, due to associated cellulitis Swelling is more marked about 4-5 mm from lid margin Tenderness Palpabral conjunctiva over the swelling is congested a pus point may be visible Pus point may be visible at the lid margin
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Hordeolum Internum
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Medical treatment is similar to treatment of Hordeoulm externum i.e. Systemic
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Lid Diseases-I - Diseases of Lids Power point copy of...

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