Specialized Pathology Part 1 - 10

like a slightly raised, slightly white bump

Yellow.

Meat dream room

The best way is to avoid the sun or wear sunglasses when going out in the sun. Do not let direct sunlight shine on your eyes. And it is better to treat early than to ignore the first symptoms such as eye irritation and itching.

Treatment of pterygium

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Medications are used to treat episodes of inflammation that cause congestion, congestion, or possibly infection to slow the progression of the disease. Eye drops cannot eliminate pterygium. In general, if the pterygium does not significantly invade the cornea, regular monitoring is continued; if it invades the pupil, surgery is performed.

Pterygium surgery

- Pterygium removal surgery is relatively simple, only requires local anesthesia and surgery time is about 10 minutes. No need to stay in hospital, only need outpatient treatment for 3 - 4 weeks.

- When the pterygium invades the pupil or obscures the pupil, surgery is necessary.

- In case the pterygium is still small, the impact on daily life must be considered before deciding on surgery. Pterygium surgery using new method

Doctors peel off the pterygium, slice it off the cornea, then create a conjunctival flap to patch it and move it to the location of the cut pterygium in the eye to patch it. In seven localities where the technique was transferred and this method was implemented, one center performed surgery on 600 patients with pterygium in the eye in 2008 with a very low recurrence rate of only 1.8%. While with the old method of cutting pterygium (without patching), the recurrence rate was up to 30-80%.

Problems after surgery

Pterygium surgery is simple, but the main concern is recurrence.

Even with careful surgery , the possibility of recurrence is still high, from 40 - 50%, often occurring in young patients. There are many methods to prevent recurrence of pterygium such as radiation, conjunctival transplantation, pterygium corneal transplantation, and chemotherapy, but none of them is completely effective.

Therefore, before deciding on surgery, patients need to carefully consider the risk of recurrence to choose surgery.

II. ENROLLMENT.

1. Definition.

Entropion is the inward rolling of part or all of the eyelid margin. The disease is severe due to corneal complications due to eyelash friction (ulcers, corneal opacity) and this is the main direct cause of blindness due to trachoma.

It is necessary to distinguish between entropion and trichiasis: Trichiasis is the misalignment of a few eyelashes while the eyelid margin remains in a normal position.

2. Clinical forms:

Age-related entropion:

Senile entropion is usually of the lower eyelid. Most senile entropion is on eyes that have sunken in due to loss of orbital fat, which removes the back support of the eyelid, causing the eyelid margin to fall back and inward.

Congenital entropion:

Inverted eyelid margin due to structural defect of cartilage

eyelid, orbicularis oculi muscle hyperplasia and skin layer.

Scar entropion:

Is a late complication of conjunctival and tarsal diseases (trachoma, Stevens- Johnson syndrome, burns)

chemicals, ocular pemphigoid …). The eyelid cartilage is bent inward, the conjunctiva of the eyelid is scarred, sometimes there is partial adhesion of the eyelid.

Spasmodic entropion:

Mainly in the lower eyelid, occurs in adults with chronic blepharospasm (due to trauma after surgery, eye inflammation). The patient squints for a long time, causing the eyelid margin to roll inward. Corneal irritation makes the entropion worse.

3. Treatment.

- Apply antibiotic ointment ( Tobramicin , Erythromycin ... 3 times/day to treat superficial punctate keratitis).

- Temporarily, you can use tape to turn the eyelid away from the eyeball.

- Surgery is often required to cure the disease.

III. CHLASMA

A chalazion is a granuloma that arises from a blocked tarsal gland. The accumulated sebum invades the surrounding tissues and causes chronic granulomatous inflammation. The lesion resolves over days to months as the invading lipids are phagocytosed; a small amount of scar tissue may remain.

Chalazion is very common and has many forms. External chalazion is a red spot on the eyelid, the size and firmness of a bean. Internal chalazion is usually more discreet, located on the inside of the eyelid, that is, the conjunctiva of the eyelid, when we turn the eyelid we can see it, in some cases we can also see the white pus tip of the chalazion. Many cases of multiple chalazion, that is, there are many chalazions on one or both eyelids, or even both eyes.

1. Cause :

Due to meibomian gland inflammation of the tarsal cartilage

2. Symptoms:

- Feeling stuck in the eyelids makes it difficult to blink.

- Examination: a small lump appears on the eyelid, maybe the size of a bean or corn kernel, feels firm to the touch, not painful. The swollen area is not red. If you turn the eyelid up, you will see the opposite swollen area is gray. The chalazion does not stick to the eyelid skin.

- Cancers of the eyelid (basal cell carcinoma or sebaceous carcinoma) can be misdiagnosed as chalazion. Therefore, if the chalazion is persistent, long-standing or atypical, especially in the elderly, histopathological examination is required.

3. Progress:

Chalazion never becomes cancerous. When it first appears, it is small and progresses slowly. It can remain the same size for several years, it can shrink, but sometimes it can grow larger, causing pus to form a secondary infected chalazion. Clinically, in addition to the above symptoms, we also see: swelling, heat, redness, pain...

Chalazion may have an acute or insidious onset. Most chalazia are sterile, so antibiotics are of no value.

4. Treatment:

- If a small chalazion does not cause discomfort, leave it alone. Advise the patient to massage and rub it daily to heal itself (use the index finger to massage the skin on the eyelid with the chalazion).

- Send large chalazion to a specialist facility for chalazion extraction.

- Hot compresses can relieve pain symptoms for early injuries.

- Chalazion usually goes away on its own after several weeks.

- Large or persistent chalazions can use corticosteroids but must be examined and monitored by a doctor. Styes can also be injected, or a combination of both methods. In addition, freezing or laser has been used experimentally in some cases and has given good results.