UWORLD Ophthalmology Step 2 CK -Abscess located over the upper or lower eyelid. -Caused by staph aureus. -Localized red, *tender swelling* over *eyelid*. -Tx: *warm compress*, incision and curettage (if persistent or large) - Answer: Hordeolum What is the likely diagnosis in a patient that presents with a hard, *painless bump* on the upper eyelid? - Answer: Chalazion (typically caused by granulomatous reaction to a *blocked meibomian gland*) Recurrent chalazion requires ........... - Answer: UWORLD Ophthalmology Step 2 CK histopathologic exam to rule out malignancy (basal cell carcinoma is the most common malignancy of the lid margin) What is the likely diagnosis in a patient that presents with *tenderness*, edema, and *redness* over the *medial canthus* of the right eye for two days? Slight pressure over the area causes expression of *purulent material*. - Answer: Dacryocystitis (infection of the *lacrimal sac*) (typically caused by Staphylococcus aureus and Streptococcus pyogenes) (Tx: systemic antibiotics; *not* lacrimal sac massage) ........... is caused by obstruction of the nasolacrimal duct and results in *crusting of the eye lashes* and *increased tearing*. The *conjunctivae* remain *clear*. – UWORLD Ophthalmology Step 2 CK Answer: Dacryostenosis What is the recommended treatment for dacryostenosis? - Answer: Nasolacrimal sac massage What is the likely diagnosis in a patient that presents with -*burning* and *itching* of the eyelids -*discharge* +/- *crusting * -*redness, swelling and scaling* of the lid margin