Herpes simplex:
- Is a unilateral condition.
- Affects children.
- Crops of small vesicles which rupture, crust, and
heal within few days.
Treatment:
- Topical acyclovir cream.
- Avoid contact with the eyes.
Herpes zoster ophthalmicus:
EYELID INFECTIONS
🔹
- Is a unilateral condition.
Caused by varicella-zoster virus.
- Typically affects the elderly & immuno-compromised patient.
- Pain in the distribution of the first division of the trigeminal nerve
(nasolacrimal), but may affect other branches (maxillary, &
mandibular).
- Maculopapular rash progresses into vesicles, pustules, & crusting
ulcerations.
- Lid edema could be bilateral.
🔹
- Hutchinson’s sign.
Treatment:
- Systemic antiviral: valacyclovir, famcyclovir.
- Topical acyclovir cream.
- Topical steroid
– antibiotic combination cream.
🔷 Acute allergic edema (angioedma):
🔷
- Sudden onset of painless, pitting lid edema.
Acute dacryocystitis:
- Subacute onset of pain, redness & tender 🔹Treatment: systemic antihistamines as: cetirizine.
- Usually caused by an insect bite, or drugs.
swelling at the medial canthus associated with
🔹
epiphora. 🔷 Contact dermatitis:
🔹 Complications:
1-Lacrimal abscess and fistula
Treatment:
- Warm fomentations.
-Hypersensitivity to topical medications (eye drops).
- Common causes: neomycin, chloramphenicol, and dorozolamide.
2-Orbital cellulitis and cavernous sinus
thrombosis.
- Systemic antibiotics as: clavulanated
amoxicillin.
- If no improvement incision & drainage of a
🔹
- Itching, lid edema, redness, crusty skin.
Treatment:
- Removal of the cause.
lacrimal abscess could be done. - When Allergic Disorders - Topical hydrocortisone 1% cream.
acute infection subsides, dacryo-cysto-
rhinostomy (DCR). 🔷 Atopic dermatitis (eczema):
- Is a chronic long-lasting skin disease with often an inherited tendency to
develop other allergic conditions e.g. asthma, &hay fever.
🔷 Chronic dacryocystitis:
- Thought to be related to an over-active immune system.- Thickened lid skin
- A painless swelling at the medial canthus associated with
epiphora & discharge.
🔹
with fissuring & crusting.
Treatment:
-emollients to hydrate the skin.
🔹 Complications:
- pressure over the lacrimal sac results in reflux of
mucopurulent discharge through the punctum (regurgitation
- Topical hydrocortisone 1% cream.
🔹
Chronic conjunctivitis test is positive).
Corneal ulcer Treatment: Is with dacryocystorhinostomy( DCR).
Liability of Endophthalmitis : after intraocular
surgery.
Lacrimal mucocele Viral wart (squamous cell papilloma):
Acute dacryocyctits
Lacrimal fistula.
Eye lid - Caused by papilloma virus.
- Pedunculated or sessile lesion with a verrucated
Eye lid and lacrimal surface.
Treatment: Surgical excision.
apparatus
lacrimal disorders
🔹 Treatment:
apparatus
- Digital massage of the lacrimal sac downwards along
the sides of the nose, before the age of 1 year, 95% 🔷 Delayed canalization of the nasolacrimal duct:
improved spontaneously. - The nasolacrimal duct is completely canalized soon after birth.
- Nearly 20% of infants manifest delayed canalization of the
disorders
- If no improvement after the age of 1 year, then Naevus:
probing and irrigation of the lacrimal system is done nasolacrimal duct in the first year of life.
- Epiphora, discharge, and sticky eyelashes may be constant or Clumps of melanocytes within the skin or mucous
under general anesthesia within the first 2 years. 90% of membranes.
cases cured. It could be repeated once more further 6% intermittent.
- Regurgitation test may be positive. - Could be pigmented or non-pigmented.
cured. - Usually with a papillomatous configuration.
- If no improvement, DCR performed between the ages - Rarely, it may convert into acute dacryocystitis.
of 3-4 years. Benign Eyelid Tumors
Capillary haemangioma (strawberry naevus):
Is a congenital, irregular, raised red lesion.
- It grows quickly during the first year of life but resolves
🔷 Congenital dacryocele
Distension of lacrimal sac by trapped amniotic fluid
spontaneously by the age of 4, or later by the age of 7.
- Needs no treatment unless huge enough to cause amblyopia.
(amniontocele) Treatment:
caused by imperforate valve of Hasner - Intralesional steroid injection, .
Bluish cystic swelling at or below medial canthus - Surgical excision.
May become secondarily infected
Do not mistake for encephalocele
🔹
pulsatile swelling above medial canthal tendon
Treatment:
Initially massage, Probing if massage fails
🔷 Basal cell carcinoma (rodent ulcer):
The most common type of eyelid cancer accounting for 90% of all cases. Most basal cell
carcinomas can be removed with surgery.Patients with basal cell carcinomas most commonly
notice a reddish nodule slowly forming on their eyelid. The tumor is most commonly found on
the lower eyelid, followed by the medial canthus and can occur on the upper eyelid.
Eyelid Tumors - It is locally invasive, does not metastasize.
Firm pearly nodule with raised rolled edges containing small dilated blood vessels & central
🔹
ulceration.
Treatment:
Surgical excision: Most basal cell carcinomas are cured when they are small
Those patients allow their tumor to invade behind the eye and become difficult or impossible
to remove. In these cases, combinations of surgery, radiation and chemotherapy may be
required to control or destroy the tumor.
🔷 Squamous cell carcinoma:
Squamous cell carcinoma of the eyelid is a rare type of eyelid cancer. It typically causes a new
growth on the eyelid, which may or may not be painful. According to Stanford Medicine,
squamous cell carcinoma accounts for around 5% of eyelid cancers. It is the second most
by fatema okoff 🔹
common type of eyelid cancer, after basal cell carcinoma.
Symptoms& Signs :
- asymptomatic in early stage.
-growth on your eyelid, Predilection for the lower eyelid & the lid margin.
-change in the appearance of the skin on your eyelid
-broken eyelid skin that does not heal-persistent eyelid infection
-loss of eyelashes
-lid swelling.
🔹
- Faster growth, does metastasize (to regional lymph nodes, orbit, & brain).
Risk factors:
-lighter skin tone, as there is less melanin to protect the skin
-Older patients, as skin cancer develops over time
Malignant Eyelid Tumors -exposure to chemicals, such as arsenic
-radiation exposure or receiving radiation therapy.
having the rare condition xeroderma pigmentosum characterized by, extreme sensitivity to the sun.
🔹
previously having squamous cell skin cancer
Treatment: -Complete resection and lid reconstructions
-radiation therapy
-chemotherapy
-targeted therapy
-cryotherapy
🔷 Sebaceous gland carcinoma:
- Very rare, but aggressive tumor.
- Mostly affects the upper lid.
- Arises either from the meibomian gland, or the gland of Zeis.
🔷 Melanoma:
- Is rare but potentially lethal.
- May be pigmented or non-pigmented.
- May arise from a previous navus.
Suspect malignancy in these conditions:
* Old age.
* Feeding blood vessels.
* Signs of inflammation.
* Fast growing &spreading.
* Changing in color.
- Is a unilateral condition.
- Affects children.
- Crops of small vesicles which rupture, crust, and
heal within few days.
Treatment:
- Topical acyclovir cream.
- Avoid contact with the eyes.
Herpes zoster ophthalmicus:
EYELID INFECTIONS
🔹
- Is a unilateral condition.
Caused by varicella-zoster virus.
- Typically affects the elderly & immuno-compromised patient.
- Pain in the distribution of the first division of the trigeminal nerve
(nasolacrimal), but may affect other branches (maxillary, &
mandibular).
- Maculopapular rash progresses into vesicles, pustules, & crusting
ulcerations.
- Lid edema could be bilateral.
🔹
- Hutchinson’s sign.
Treatment:
- Systemic antiviral: valacyclovir, famcyclovir.
- Topical acyclovir cream.
- Topical steroid
– antibiotic combination cream.
🔷 Acute allergic edema (angioedma):
🔷
- Sudden onset of painless, pitting lid edema.
Acute dacryocystitis:
- Subacute onset of pain, redness & tender 🔹Treatment: systemic antihistamines as: cetirizine.
- Usually caused by an insect bite, or drugs.
swelling at the medial canthus associated with
🔹
epiphora. 🔷 Contact dermatitis:
🔹 Complications:
1-Lacrimal abscess and fistula
Treatment:
- Warm fomentations.
-Hypersensitivity to topical medications (eye drops).
- Common causes: neomycin, chloramphenicol, and dorozolamide.
2-Orbital cellulitis and cavernous sinus
thrombosis.
- Systemic antibiotics as: clavulanated
amoxicillin.
- If no improvement incision & drainage of a
🔹
- Itching, lid edema, redness, crusty skin.
Treatment:
- Removal of the cause.
lacrimal abscess could be done. - When Allergic Disorders - Topical hydrocortisone 1% cream.
acute infection subsides, dacryo-cysto-
rhinostomy (DCR). 🔷 Atopic dermatitis (eczema):
- Is a chronic long-lasting skin disease with often an inherited tendency to
develop other allergic conditions e.g. asthma, &hay fever.
🔷 Chronic dacryocystitis:
- Thought to be related to an over-active immune system.- Thickened lid skin
- A painless swelling at the medial canthus associated with
epiphora & discharge.
🔹
with fissuring & crusting.
Treatment:
-emollients to hydrate the skin.
🔹 Complications:
- pressure over the lacrimal sac results in reflux of
mucopurulent discharge through the punctum (regurgitation
- Topical hydrocortisone 1% cream.
🔹
Chronic conjunctivitis test is positive).
Corneal ulcer Treatment: Is with dacryocystorhinostomy( DCR).
Liability of Endophthalmitis : after intraocular
surgery.
Lacrimal mucocele Viral wart (squamous cell papilloma):
Acute dacryocyctits
Lacrimal fistula.
Eye lid - Caused by papilloma virus.
- Pedunculated or sessile lesion with a verrucated
Eye lid and lacrimal surface.
Treatment: Surgical excision.
apparatus
lacrimal disorders
🔹 Treatment:
apparatus
- Digital massage of the lacrimal sac downwards along
the sides of the nose, before the age of 1 year, 95% 🔷 Delayed canalization of the nasolacrimal duct:
improved spontaneously. - The nasolacrimal duct is completely canalized soon after birth.
- Nearly 20% of infants manifest delayed canalization of the
disorders
- If no improvement after the age of 1 year, then Naevus:
probing and irrigation of the lacrimal system is done nasolacrimal duct in the first year of life.
- Epiphora, discharge, and sticky eyelashes may be constant or Clumps of melanocytes within the skin or mucous
under general anesthesia within the first 2 years. 90% of membranes.
cases cured. It could be repeated once more further 6% intermittent.
- Regurgitation test may be positive. - Could be pigmented or non-pigmented.
cured. - Usually with a papillomatous configuration.
- If no improvement, DCR performed between the ages - Rarely, it may convert into acute dacryocystitis.
of 3-4 years. Benign Eyelid Tumors
Capillary haemangioma (strawberry naevus):
Is a congenital, irregular, raised red lesion.
- It grows quickly during the first year of life but resolves
🔷 Congenital dacryocele
Distension of lacrimal sac by trapped amniotic fluid
spontaneously by the age of 4, or later by the age of 7.
- Needs no treatment unless huge enough to cause amblyopia.
(amniontocele) Treatment:
caused by imperforate valve of Hasner - Intralesional steroid injection, .
Bluish cystic swelling at or below medial canthus - Surgical excision.
May become secondarily infected
Do not mistake for encephalocele
🔹
pulsatile swelling above medial canthal tendon
Treatment:
Initially massage, Probing if massage fails
🔷 Basal cell carcinoma (rodent ulcer):
The most common type of eyelid cancer accounting for 90% of all cases. Most basal cell
carcinomas can be removed with surgery.Patients with basal cell carcinomas most commonly
notice a reddish nodule slowly forming on their eyelid. The tumor is most commonly found on
the lower eyelid, followed by the medial canthus and can occur on the upper eyelid.
Eyelid Tumors - It is locally invasive, does not metastasize.
Firm pearly nodule with raised rolled edges containing small dilated blood vessels & central
🔹
ulceration.
Treatment:
Surgical excision: Most basal cell carcinomas are cured when they are small
Those patients allow their tumor to invade behind the eye and become difficult or impossible
to remove. In these cases, combinations of surgery, radiation and chemotherapy may be
required to control or destroy the tumor.
🔷 Squamous cell carcinoma:
Squamous cell carcinoma of the eyelid is a rare type of eyelid cancer. It typically causes a new
growth on the eyelid, which may or may not be painful. According to Stanford Medicine,
squamous cell carcinoma accounts for around 5% of eyelid cancers. It is the second most
by fatema okoff 🔹
common type of eyelid cancer, after basal cell carcinoma.
Symptoms& Signs :
- asymptomatic in early stage.
-growth on your eyelid, Predilection for the lower eyelid & the lid margin.
-change in the appearance of the skin on your eyelid
-broken eyelid skin that does not heal-persistent eyelid infection
-loss of eyelashes
-lid swelling.
🔹
- Faster growth, does metastasize (to regional lymph nodes, orbit, & brain).
Risk factors:
-lighter skin tone, as there is less melanin to protect the skin
-Older patients, as skin cancer develops over time
Malignant Eyelid Tumors -exposure to chemicals, such as arsenic
-radiation exposure or receiving radiation therapy.
having the rare condition xeroderma pigmentosum characterized by, extreme sensitivity to the sun.
🔹
previously having squamous cell skin cancer
Treatment: -Complete resection and lid reconstructions
-radiation therapy
-chemotherapy
-targeted therapy
-cryotherapy
🔷 Sebaceous gland carcinoma:
- Very rare, but aggressive tumor.
- Mostly affects the upper lid.
- Arises either from the meibomian gland, or the gland of Zeis.
🔷 Melanoma:
- Is rare but potentially lethal.
- May be pigmented or non-pigmented.
- May arise from a previous navus.
Suspect malignancy in these conditions:
* Old age.
* Feeding blood vessels.
* Signs of inflammation.
* Fast growing &spreading.
* Changing in color.
