Question 1

A patient reports using artificial tears for comfort because of burning and itching in both eyes but reports worsening symptoms. The provider notes redness and discharge along the eyelid margins with clear conjunctivae. What is the recommended treatment?

A) Antibiotic solution drops four times daily
B) Warm compresses, lid scrubs, and antibiotic ointment
C) Oral antibiotics given prophylactically for several months
D) Reassurance that this is a self-limiting condition

B

Accepted Answer

The symptoms and physical exam findings suggest blepharitis, which is commonly treated with warm compresses, lid scrubs, and antibiotic ointment. Artificial tears may provide temporary relief but do not address the underlying inflammation and infection. Oral antibiotics may be considered in severe cases, but prophylactic treatment for several months is not typically necessary. Simple reassurance is not appropriate given the presence of symptoms and objective findings.

Question 2

A child has a localized nodule on one eyelid which is warm, tender, and erythematous. On examination, the provider notes clear conjunctivae and no discharge. What is the recommended treatment?&#10;A) Referral to an ophthalmologist&#10;B) Surgical incision and drainage&#10;C) Systemic antibiotics&#10;D) Warm compresses and massage of the lesion

Accepted Answer

The presentation is consistent with a chalazion, which is a non-infectious granulomatous inflammation of the meibomian gland. Warm compresses and massage can help promote resolution of the lesion by improving gland drainage. Referral to an ophthalmologist is not necessary at this time, and surgical incision is reserved for larger or persistent chalazia. Systemic antibiotics would not be indicated for a non-infectious process.

Question 3

A patient has a gradually enlarging nodule on one upper eyelid and reports that the lesion is painful. On examination, the lesion appears warm and erythematous. The provider knows that this is likely to be which type of lesion?

A) Blepharitis
B) Chalazion
C) Hordeolum
D) Meibomian

C

Accepted Answer

The gradual onset, painful nature, and warmth of the lesion suggest an infection, most likely a hordeolum (also known as a stye). Blepharitis is inflammation of the eyelid margins, but does not typically present as a nodule. A chalazion is a painless, firm nodule on the eyelid that is not typically warm or erythematous. Meibomian refers to the glands in the eyelid that secrete oil to lubricate the eye, and is not a type of lesion.

Deck 54: Blepharitis, Hordeolum, and Chalazion