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16 - Periocular Infections

from Part III - Clinical Syndromes – Eye

Published online by Cambridge University Press:  05 March 2013

Marlene L. Durand
Affiliation:
Massachusetts General Hospital
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
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Summary

Periocular infections are infections of the soft tissue surrounding the globe of the eye. These include infections of the eyelids, lacrimal system, and orbit. These are often managed by ophthalmologists with oculoplastics expertise; orbital infections are usually managed in conjunction with otolaryngologists and infectious disease physicians.

EYELID INFECTIONS

Each eyelid contains a fibrous tarsal plate that gives structure to the lid. Within each tarsal plate are 20 to 25 vertical meibomian glands that secrete sebum at the lid margins. Glands of Zeis, smaller sebaceous glands adjacent to the lid margin hair follicles, also secrete sebum. Sebum prevents ocular surface drying by keeping the tear film from evaporating too quickly.

Hordeolum

An internal hordeolum is an acute infection of a meibomian gland. Patients present with a tender area of swelling and erythema within the lid, pointing either to the skin or conjunctival surface. An external hordeolum (or stye) is an acute infection of a gland of Zeis and points to the lid margin. Both are usually caused by Staphylococcus aureus and respond to frequent warm compresses and topical bacitracin or erythromycin ointment.

Chalazion

A chalazion is a nontender nodule within the lid that points to the conjunctival surface and is due to a sterile granulomatous reaction to inspissated sebum within a meibomian gland. Most chalazia resolve spontaneously within 1 month, but persistent or recurrent chalazia should be biopsied to exclude squamous cell carcinoma.

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Publisher: Cambridge University Press
Print publication year: 2008

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