Focus on Ophthalmopathology - Orbital Infections from Hordeolum to Necrotizing Fasciitis. / Schwerpunkt Ophthalmopathologie Orbitainfektion: vom Hordeolum bis zur nekrotisierenden Fasziitis.

(Peri)orbital infections comprise a multitude of diagnoses, ranging from common hordeolum to rare but life-threatening necrotizing fasciitis. However, these disease entities are rarely diagnosed by an ophthalmic pathologist because (peri)orbital infections are usually diagnosed clinically, with the help of imaging and microbiological techniques when indicated. In this review article, the role of ophthalmopathology in the diagnosis of (peri)orbital infections is illustrated on the basis of several exemple diagnoses. An infectious hordeolum must be distinguished from a noninfectious chalazion. A nodular thickening of the eyelid, which is diagnosed and treated as a chalazion, can hide a malignant neoplasia. The correct diagnosis and treatment of canaliculitis is often delayed. In this context the most common causative organism, Actinomyces, can be depicted histologically, as can lacrimal stones/dacryoliths. Necrotizing fasciitis is a rapidly worsening infection of the fascia, which can lead to necrosis, sepsis, and death. During the Sars-CoV2 pandemic, an increased incidence of mucormycosis cases was observed, especially in India. This superinfection was facilitated by the widespread use of steroids and immunosuppression. Histologically, it is possible to visualize infiltration of vessel walls by the fungus. Ophthalmopathology contributes to the diagnosis and to understanding the pathophysiology of these diseases.

[Hordeolum and chalazion : (Differential) diagnosis and treatment]. / Hordeolum und Chalazion : (Differenzial­)Diagnose und Therapie.

Hordeolum and chalazion are the most frequent inflammatory eyelid tumors. They can occur in association with underlying diseases causing Meibomian gland dysfunction and/or chronic blepharitis. Due to the typical morphological features and clinical course, the diagnosis can mostly be clinically established. The majority of these lesions resolve spontaneously over time. In some instances, surgical intervention is unavoidable. In persistent, recurrent or clinically atypical cases malignant tumors must be excluded as a differential diagnosis by excisional biopsy and histopathological assessment.

Common inflammatory and infectious conditions of the eyelid.

Patients with infection or inflammation of the eyelid will often first present to their primary care physicians with symptoms such as redness, swelling, tearing, itchiness, or a foreign body sensation. There are a variety of conditions that affect the eyelid which can cause such symptoms, and the exam and history can help a provider differentiate some of the more common conditions. This article will provide a comprehensive review of the background, diagnosis and management of dry eye disease, chalazion, hordeolum (stye), and preseptal cellulitis.

Comparative Clinical Outcomes of Pediatric Patients Presenting With Eyelid Nodules of Idiopathic Facial Aseptic Granuloma, Hordeola, and Chalazia.

PURPOSE: To present the clinical features of the eyelid nodules observed in a newly determined dermatologic disorder, idiopathic facial aseptic granuloma (IFAG), and to compare them with children having acute hordeolum and chalazion. METHODS: Duration of the lesion, localization, presence of coexisting facial nodules, management strategies, and response time to topical/oral antibiotics were retrospectively reviewed in 50 children with IFAG, acute hordeolum, or chalazion. RESULTS: Fourteen children with one or more IFAG nodules on their eyelids, 28 children with one or more acute hordeolum, and 8 children with one or more chalazion were examined. Children with IFAG on their eyelids and face presented earlier than children with acute hordeolum (P = .006). The duration of this lesion was similar among patients with IFAG on their eyelids and acute hordeolum (P = .53). Duration of the lesion and treatment response time were shorter in children with IFAG on their eyelids and face (P = .004) than in those with IFAG on their eyelids (P = .013). The lesions of patients with chalazion had a longer duration compared to those with IFAG on their eyelids (P = .005), IFAG on their eyelids and face (P < .001), and acute hordeolum (P = .04). Twenty patients with acute hordeolum recovered after topical antibiotics and had a similar treatment response time to those with IFAG on their eyelids and face (P = .06) and those with IFAG on their eyelids (P = .16). CONCLUSIONS: IFAG should be considered in the differential diagnosis of painless eyelid nodules in children. Because IFAG on the eyelids has many overlapping features with hordeola/chalazia, its differentiation may be difficult in the absence of accompanying facial granulomas. Chronic subepidermal eyelid nodules resembling skin abscess should alert clinicians for IFAG. Because IFAG responds well to oral clarithromycin, unnecessary surgical interventions should be avoided in these cases. [J Pediatr Ophthalmol Strabismus. 2016;53(4):206-211.].

[Eye lid reconstruction after bilateral palpebral complete necrosis after an extensive Pseudomonas aeruginosa infection (infected neonatal hordeolum)]. / Reconstructie palpebrala dupa necroza bilaterala completa de pleoape, cu postinfectie locala extensiva cu Pseudomonas aeruginosa (orjelet neona- tal suprainfectat).

In this article we will present a clinical case particularly interesting in terms of diagnosis, treatment and evolution of a infant who presented in our service because very serious evolution of a hordeolum, with infection and then complete necrosis of lower and upper eyelids of both eyes. The substrate counterproductive evolution was identified later, by genetic analysis (X-linked Bruton congenital agammaglobulinemia).

Multiple recurrent hordeola associated with selective IgM deficiency.

An external hordeolum is an acute, suppurative inflammation of the glands of Zeis and sweat glands or hair follicles most commonly caused by staphylococci, usually in the setting of a chronic blepharitis.(1) We report a case of a boy with unilateral multiple recurrent hordeola in association with selective IgM deficiency.

Emergencias en oftalmología: cuándo derivar al especialista? / Emergency in oftalmology: when overthrow to the specialist?

En este artículo se comentarán los cuadros de mayor frecuencia que afectan al ojo, y que pueden ser abordados directamente por el pediatra. Se analizarán tambien los signos de riesgo que permiten determinar el momento en que el paciente debe referirse, en forma mas o menos urgente, al oftalmólogo

Blepharitis.

Blepharitis is an acute or chronic inflammatory process involving the eyelids that is frequently associated with conjunctivitis. In its many clinical forms, blepharitis is one of the most common diseases seen by ophthalmologists; yet it remains a diagnostic and therapeutic challenge. This article reviews the clinical presentation, classification, diagnosis, etiology and pathogenesis, and treatment of blepharitis.

[Eyelid tumors]. / Les tumeurs palpébrales.

This review is intended to every general practitioner who is dealing with the daily problems of benign cystic palpebral tumors. Clinical presentation and treatment are reviewed. The necessity to recognize and treat malignant tumors of the eyelids early is re-emphasized.

Guias de manejo clinico: conjuntivitis orzuelo y blefaritis / Guides of clinical management: conjuntivitis hordeolum and blepharitis

Los procesos inflamatorios oculares son un frecuente motivo de consulta al medico general. La inflamacion ocular puede ser de origen infeccioso (bacterias y virus principalmente) o secundaria a una enfermedad inflamatoria sistemica. La conjuntivitis, el orzuelo y la blefaritis son las infecciones oculares mas frecuentes. En este articulo los autores revisan la manera de enfocar el diagnostico y el tratamiento de estos problemas en la actualidad