Ulcerative form - Answer: • Involves the lash follicle and the meibomian glands of the eyelid
• May be pustules at the base of the hair follicles that may crust and bleed
• Lashes become thin and break easily
Hordeolum - Answer: • An ***acutely*** presenting, erythematous, tender lump within the eyelid
• External hordeolum: inflammation/***infection*** of the eyelid margin affecting the hair follicles of
the eyelashes
• Internal hordeolum: inflammation/infection of the meibomian glands
**Treat with warm compresses and opthalmic ATB ointment such as erythromycin for internal
hordeolum**
Chalazion - Answer: • A granulomatous blocked **meibomian gland**, presenting in the form of
painless swelling on the eyelid (a hordoleum that does not resolve)
**slow developing, painless, hard mass (pea sized nodule within the eyelid)***
• Initially may be tender and erythematous before evolving into a nontender lump
• Blepharitis is frequently associated with chalazia
Conjunctivitis - Answer: • Conjunctivitis: inflammation of the conjunctiva covering the front of the eye
Common causes
• Infectious agents: bacterial, viral, or fungal
,• Sexual transmission and ophthalmia neonatorum
• Herpes simplex virus (HSV) I
• Trachoma
• Toxicity (from an inciting agent of some sort)
• Allergy
Conjunctivitis: Diagnostic Tests
******Check visual acuity first******
• Dilated pupil exam for proptosis, optic nerve dysfunction, decreased visual acuity, diplopia, or anterior
chamber inflammation
• Fluorescein staining to rule out corneal involvement or keratitis
• Blue penlight illumination to see corneal scratches, corneal dendrites, or corneal ulceration
Otitis Media (OM) - Answer: • Otitis media with effusion (OME): transudation of plasma from middle
ear blood vessels, leading to chronic effusion in the ***absence**** of the signs and symptoms of acute
infection; caused by blocked eustachian tube
decreased hearing may result; fluid but no inflammation
• Acute otitis media (AOM): suppurative OM or purulent OM
• Recurrent OM: the clearance of middle ear effusions between acute episodes of otic inflammation
• Chronic OM: inflammation persists more than 3 months, typically related to tympanic membrane
perforation with either intermittent or persistent otic discharge
OME: Subjective - Answer: • Stuffiness, fullness, and a loss of auditory acuity in the affected ear only
• Pain is rare; may describe popping, crackling, or gurgling sounds when chewing, yawning, or blowing
the nose
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