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Meibomian cyst - Coggle Diagram
Meibomian cyst
assessment
take history, ask about lesion character, speed, onset, progression and duration
Meibomian cyst usually present as a firm lump in the upper or lower eyelid, slowly develops over weeks
lesion maybe tender
occasionally two or more lesions may occur on a single lid, one or both eyelids maybe affected
ask about symptoms, size, astigmatism, vision loss affecting eye closure symptoms such as pain, redness, burning, itching, limited eye movement, fever, malaise, may suggest a risk factor
ask about medical history /conditions that may increase risk of Meibomian cyst
ask about known triggers, contact lens, applying cosmetics, fragrances, haircare products, recurrent issues
examine person, look for signs of Meibomian cyst, look for diffused swelling of the lid,
assess for differentials, risk factors, red flags
risk factors
acute syle
chronic blepharitis
seborrheic dermatitis
rosacea
diabetes
elevated cholesterol
pregnancy
complications
visual disturbance
cellulitis, orbital and periorbital
skin changes
definition
chronic non infectious inflammatory granuloma caused by the blockage of Meibomian gland duct
a set of glands running along eyelid margin, obstruction of these glands cause enlargement of the gland and potential to rupture, releasing accumulated lipid contents into the surrounding eyelid soft tissue
differential diagnosis
stye
dacryocystitis
dacryoadenitis
sebaceous cyst
eye lid cancer
management
consider the need for admission or referral, arrange same day referral to ophthalmology of A&E, is there are signs and symptoms of periorbital or orbital cellulitis
rif cancer suspected refer for assessment via cancer pathway if signs or symptoms suggesting a malignancy
refer to ophthalmology if lesion: large, causing corneal distortion, interfering with eyelid function, or cosmetically unacceptable , also consider reffering to opthamology if the person is a young child
if managed in primary care: reassure them that usually resolves within weeks or months and rarely cause any serious complications
offer written information. advise on conservative treatment,
apply warm compress, massage eyelid,
if no improvement after 4 weeks of conservative management: consider the following options depending on clinical judgement: no treatment, reassure person usually resolves within 6 months with conservative treatment, consider referral to ophthalmology
it no improvement after 6 months of conservative treatment or recurrent: refer to ophthalmology for further assessment, invasive treatment such as incision or injectable steroids maybe an option for treatment, further investigations to rule out serious condition such as eyelid cancer