EYE
UKMLA Conditions Categorised by Body System
,Acute (Angle-Closure) Glaucoma
A sudden rise in intraocular pressure due to obstruction of aqueous outflow at the iridocorneal angle — an ophthalmic emergency.
Key clinical features
• Severe unilateral eye pain, blurred vision, and haloes around lights.
• Headache, nausea and vomiting.
• Red eye with a hazy/cloudy cornea; fixed, mid-dilated pupil; the eye feels firm/hard on gentle palpation.
• Risk factors: hypermetropia (long-sightedness), older age, family history, and pupillary dilation (dark rooms, anticholinergic
medications).
Investigations
• Tonometry — markedly elevated intraocular pressure (often well above 21mmHg).
• Gonioscopy to assess the angle.
• Often a clinical diagnosis given the classic presentation.
Treatment and management
• Emergency referral to ophthalmology.
• IV acetazolamide to reduce aqueous production; topical beta-blockers (timolol).
• Topical pilocarpine once IOP starts to fall, to constrict the pupil and open the angle; topical steroids for inflammation.
• Definitive treatment: laser peripheral iridotomy, performed in both eyes as the fellow eye is also at risk.
• Analgesia and antiemetics for symptom relief.
Complications
• Permanent vision loss/blindness if untreated
• Optic nerve damage
• Recurrent episodes; the fellow eye remains at risk
, Benign Eyelid Disorders
Common non-malignant eyelid conditions, including blepharitis (chronic lid margin inflammation), ectropion (outward-turning lid),
entropion (inward-turning lid), chalazion (blocked meibomian gland), and hordeolum (stye — an infective lash follicle/gland swelling).
Key clinical features
• Blepharitis: red, itchy, gritty eyelid margins with crusting; often associated with dry eye or rosacea.
• Ectropion: outward-turning lower eyelid, watery eye, risk of exposure keratopathy; more common with age-related lid laxity.
• Entropion: inward-turning eyelid causing lashes to rub the cornea, with irritation and risk of corneal abrasion.
• Chalazion: firm, painless nodule within the eyelid, away from the lid margin, from a blocked meibomian gland.
• Hordeolum (stye): painful, red, tender swelling at the eyelid margin, often pointing with pus.
Figure 1: Comparison of common benign eyelid disorders.
Investigations
• Usually a clinical diagnosis.
Treatment and management
• Blepharitis: lid hygiene (warm compresses, lid massage/cleaning), artificial tears for associated dry eye.
• Ectropion/entropion: lubricants or taping for mild cases; surgical correction if symptomatic or persistent.
• Chalazion: warm compresses and massage (often resolves spontaneously); incision and curettage if persistent.
• Hordeolum: warm compresses; topical antibiotics if associated conjunctivitis; incision/drainage rarely needed.
Complications
• Exposure keratopathy (ectropion)
• Corneal abrasion/ulceration (entropion)
• Recurrent chalazion
• Preseptal cellulitis, from spread of hordeolum infection
UKMLA Conditions Categorised by Body System
,Acute (Angle-Closure) Glaucoma
A sudden rise in intraocular pressure due to obstruction of aqueous outflow at the iridocorneal angle — an ophthalmic emergency.
Key clinical features
• Severe unilateral eye pain, blurred vision, and haloes around lights.
• Headache, nausea and vomiting.
• Red eye with a hazy/cloudy cornea; fixed, mid-dilated pupil; the eye feels firm/hard on gentle palpation.
• Risk factors: hypermetropia (long-sightedness), older age, family history, and pupillary dilation (dark rooms, anticholinergic
medications).
Investigations
• Tonometry — markedly elevated intraocular pressure (often well above 21mmHg).
• Gonioscopy to assess the angle.
• Often a clinical diagnosis given the classic presentation.
Treatment and management
• Emergency referral to ophthalmology.
• IV acetazolamide to reduce aqueous production; topical beta-blockers (timolol).
• Topical pilocarpine once IOP starts to fall, to constrict the pupil and open the angle; topical steroids for inflammation.
• Definitive treatment: laser peripheral iridotomy, performed in both eyes as the fellow eye is also at risk.
• Analgesia and antiemetics for symptom relief.
Complications
• Permanent vision loss/blindness if untreated
• Optic nerve damage
• Recurrent episodes; the fellow eye remains at risk
, Benign Eyelid Disorders
Common non-malignant eyelid conditions, including blepharitis (chronic lid margin inflammation), ectropion (outward-turning lid),
entropion (inward-turning lid), chalazion (blocked meibomian gland), and hordeolum (stye — an infective lash follicle/gland swelling).
Key clinical features
• Blepharitis: red, itchy, gritty eyelid margins with crusting; often associated with dry eye or rosacea.
• Ectropion: outward-turning lower eyelid, watery eye, risk of exposure keratopathy; more common with age-related lid laxity.
• Entropion: inward-turning eyelid causing lashes to rub the cornea, with irritation and risk of corneal abrasion.
• Chalazion: firm, painless nodule within the eyelid, away from the lid margin, from a blocked meibomian gland.
• Hordeolum (stye): painful, red, tender swelling at the eyelid margin, often pointing with pus.
Figure 1: Comparison of common benign eyelid disorders.
Investigations
• Usually a clinical diagnosis.
Treatment and management
• Blepharitis: lid hygiene (warm compresses, lid massage/cleaning), artificial tears for associated dry eye.
• Ectropion/entropion: lubricants or taping for mild cases; surgical correction if symptomatic or persistent.
• Chalazion: warm compresses and massage (often resolves spontaneously); incision and curettage if persistent.
• Hordeolum: warm compresses; topical antibiotics if associated conjunctivitis; incision/drainage rarely needed.
Complications
• Exposure keratopathy (ectropion)
• Corneal abrasion/ulceration (entropion)
• Recurrent chalazion
• Preseptal cellulitis, from spread of hordeolum infection
