3-13. EYELID DISORDERS
a. Chalazion. Chalazion is one of the three most common eyelid infections.
(The other two are blepharitis and Phthirius pubis.) This infection is a common
inflammation of a meibomian gland. It is characterized by localized swelling of the
eyelids or a small or hard tumor. The infection may be preceded by a stye. There may
be no inflammatory signs. The treatment for this condition is a surgical excision
performed by a doctor. There may be some complications of chalazion such as cellulitis
(spread of infection) over the entire eyelid. Another possible complication is
astigmatism (faulty vision caused by imperfections in the curvature of the cornea).
Astigmatism is caused by the pressure of the constantly swollen eyelid on the eyeball.
Astigmatism results in uneven focusing in different planes, and the patient experiences
visual distortion.
b. Blepharitis. This condition, an inflammation involving hair follicles and
surface glands of the eyelids, is a common problem which affects the lid margins of both
eyelids. The condition may be ulcerative or nonulcerative. Other conditions almost
always associated with blepharitis are seborrhea of the scalp, the brows, and frequently
the ears. Symptoms include sore eyelids and itching of the eyelid margins due to sticky
exudate. Treatment of blepharitis consists of soap and water. Shampoo the scalp,
eyebrows, and lid margins. Antibiotics applied topically may also be used.
c. Phthirius pubis. A third eyelid disorder, Phthirius pubis, is an infection
caused by a crab louse which infects the eyebrow and the eyelid margins. The louse
releases feces which irritate the affected areas and cause conjunctivitis. The symptom
of the condition is an intense itching of the eye region. Treat the condition with
mechanical removal of the louse and Kwell shampoo.
3-14. ANTIBACTERIAL MEDICATIONS FOR EYE DISEASES
a. Introduction. Antibacterial medications are indicated for the treatment of
superficial bacterial infections of the eye such as conjunctivitis, styes, and blepharitis.
Secondary infection due to injury or viral infection should be prevented. The topical use
of antibiotics, commonly used systemically, should be avoided because of possible
sensitization in future use. Some preparations that can be used as antibacterial
medications include sodium sulfacetamide (Sulamyd), bacitracin ophthalmic, and
gentamicin (Garamycin).
b. Sodium Sulfacetamide (Sulamyd). This medication may be used as a
solution 10 to 30 percent or ointment 19 percent. The procedure consists of instilling
one or two drops frequently, depending on the severity of the infection. Its bacteriostatic
action is a broad spectrum against gram-positive and gram-negative organisms which
inhibit the growth of microorganisms. The medication is contra-indicated in sulfa
hypersensitive patients. Usually sodium sulfa-cetamide is ineffective in the presence of
large or heavy purulent discharge.
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