Louse Infestation of the Eyelids

This refers to infestation of the margin of the eyelid with crab lice as a result of poor hygienic conditions. The small oval nits frequently hang from the eyelashes (Fig. 2.16), causing inflammation of the margin of the eyelid with severe itching. Mechanical removal with forceps is a time consuming but effective treatment. Application of a 2% mercury precipitate ointment over an extended period of time is also effective.

— Louse infestation of the eyelids. -

Fig. 2.16 Under poor hygienic conditions, crab lice can infest the bases of the eyelashes.

— Louse infestation of the eyelids. -

38 2 The Eyelids 2.6 Disorders of the Eyelid Glands 2.6.1 Hordeolum Definition

A hordeolum is the result of an acute bacterial infection of one or more eyelid glands.

Epidemiology and etiology: Staphylococcus aureus is a common cause of hordeolum. External hordeolum involves infection of the glands of Zeis or Moll. Internal hordeolum arises from infection of the meibomian glands. Hordeolum is often associated with diabetes, gastrointestinal disorders, or acne.

Symptoms and diagnostic considerations: Hordeolum presents as painful nodules with a central core of pus. External hordeolum appears on the margin of the eyelid where the sweat glands are located (Fig. 2.17). Internal hordeolum of a sebaceous gland is usually only revealed by everting the eyelid and usually accompanied by a more severe reaction such as conjunctivitis or che-mosis of the bulbar conjunctiva. Pseudoptosis and swelling of the preauricu-lar lymph nodes may also occur.

Differential diagnosis: Chalazion (tender to palpation) and inflammation of the lacrimal glands (rarer and more painful).

Treatment: Antibiotic ointments and application of dry heat (red heat lamp) will rapidly heal the lesion.

— External hordeolum.

— External hordeolum.

Fig. 2.17 The painful inflamed hordeolum is usually caused by Staphylococcus aureus infection of an eyelid gland.

Fig. 2.17 The painful inflamed hordeolum is usually caused by Staphylococcus aureus infection of an eyelid gland.

2.6 Disorders of the Eyelid Glands 39 ^

Clinical course and prognosis: After eruption and drainage of the pus, the symptoms will rapidly disappear. The prognosis is good. An underlying internal disorder should be excluded in cases in which the disorder frequently recurs.

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