American Medical Association Family Medical Guide - American Medical Association [731]
Symptoms, Diagnosis, and Treatment
The symptoms of ectropion include pain and redness in the eye, inflammation, discharge and crusting of mucus, infections, vision problems, and watering eye (see page 1038).
A diagnosis of ectropion is based on the symptoms and an examination of the affected eyelid. Because ectropion rarely goes away on its own, the doctor will probably recommend surgery to tighten the lower eyelid and move it back to its normal position beneath the eye. The procedure is usually performed using local anesthesia in a doctor’s office or in an outpatient facility.
Blepharitis
Blepharitis is inflammation of the eyelids. The disorder occurs more often in people who have dandruff (see page 1075), oily skin, dry eye (see next page), rosacea (see page 1066), or seborrheic dermatitis (see page 1063). In some cases, a bacterial infection develops and makes the condition worse. Often, flakes from the eyelids enter the eye and cause an inflammatory condition called conjunctivitis (see page 1038).
In severe cases of blepharitis, small ulcers may develop on the edges of the eyelids and, in rare cases, the eyelashes may fall out. Persistent inflammation can lead to the development of corneal ulcers (see next page).
Symptoms, Diagnosis, and Treatment
The symptoms of blepharitis include redness, itching, and swelling of the eyelids; greasy, scaly, flaky upper and lower eyelids; and discharge and crusting of mucus around the eyes.
A diagnosis of blepharitis is based on the symptoms and an examination of the eye. To treat blepharitis, a doctor may recommend gently washing away the scaly flakes (morning and night) with a clean, soft washcloth moistened with a solution of warm water and mild, diluted baby shampoo. Rinse the affected area with warm water and pat it dry with a clean, soft towel. If the condition does not improve within 2 weeks, the doctor may prescribe an antibiotic ointment to rub into the edges of the eyelids after washing. He or she may also prescribe eyedrops containing a corticosteroid drug to relieve inflammation. Blepharitis often recurs after treatment.
Disorders of the Outer Eye
A sensitive, transparent mucous membrane called the conjunctiva lines most of the visible surface of the eye (except for the cornea) and the inner surface of each eyelid. A thin film of watery fluid (tears), which is produced by the lacrimal glands above each eyeball and by glands in the conjunctiva, lubricates and cleanses the eye and allows the lid to move over it smoothly as you blink. Tears drain away from each eye along two channels called the lacrimal canals. A tiny hole (lacrimal punctum) at the inner edge of each eyelid marks the opening of the channel, which leads to the lacrimal sac at the side of the nose. From there, the tears pass down the nasolacrimal duct into the nasal cavity.
The outer eye
Dry Eye
Dry eye is a condition that results from inadequate tear production. Although dry eye often occurs in people who have rheumatoid arthritis (see page 918) or Sjögren’s syndrome (see page 926), in many cases the condition occurs for no obvious reason. Dry eye usually develops in middle age and affects women more often than men. Usually both eyes are affected.
Symptoms
In dry eye, the conjunctiva (the transparent membrane that covers the white of the eye and lines the eyelids) may become red and swollen. The eye may feel irritated and gritty. Other possible symptoms include a dry mouth and joint pain.
Diagnosis and Treatment
A diagnosis of dry eye is based on the symptoms and an examination of the eye. To relieve discomfort, the doctor will probably prescribe eyedrops called artificial tears, which you may need to use for the rest of your life. In severe cases of dry eye, doctors may prescribe lubricating ointments or