2/28/2023 0 Comments Unequal pupil size after sltMany patients have lumps and bumps around their ocular adnexa, but most patients do not realize that optometrists can easily take care of these small annoyances. 2 BENIGN LESION REMOVAL AND LESION BIOPSY This strategy limits steroid diffusion, allowing the agent to act effectively on the remaining granuloma. Large or multiloculated chalazia may respond best to I&C followed by intralesional administration of a steroid while the chalazion clamp is still in place. A TA injection might make more sense if the chalazion has been present for 6 months or less, if the patient has an allergy to anesthetics, if the lesion is near the punctum, or if multiple lesions are present. For example, if a patient has darkly pigmented skin, or multiple TA injections have failed to resolve the chalazion, I&C may be the better option. There is a time and a place for both TA and I&C. Moreover, patients in the TA group reported experiencing less pain and inconvenience than those in the I&C group. 1 After 3 weeks, a single TA injection followed by lid massage resulted in chalazion resolution in 84% of patients compared with 87% resolution in the I&C group and 46% in the hot compress group. Notice the complete resolution of the right upper eyelid chalazion.Ī prospective randomized study by Goawalla and Lee compared three methods of chalazion treatment: intralesional TA injection (0.2 mL of 10 mg/mL), I&C, and hot compresses. Large right upper eyelid chalazion present for 3 months (A). When chalazia are persistent, surgical intervention, such as an injection of triamcinolone acetonide (TA Kenalog, Bristol-Myers Squibb) or incision and curettage (I&C) may be needed for full resolution (Figure 1).įigure 1. Conservative treatment usually includes warm compresses with lid massage or doxycycline 50 mg administered twice daily for 1 month. One of the most common benign lid lesions, chalazion, forms when lipid byproducts are exuded into the surrounding tarsal plate stroma and incite a granulomatous inflammatory response. CHALAZION INJECTIONS AND INCISION AND CURETTAGE This article reviews common in-office surgical procedures that any optometrist can perform if allowed to do so by state law. Modern optometric practice is multifaceted, and the demand for optometric service is booming. Optometrists in several states can perform laser procedures to address the most frequent complication of cataract surgery and to manage glaucoma and angle closure.Radiofrequency therapy is a useful option for treating both trichiasis and dry eye disease.Optometrists can treat a variety of common lesion types in accordance with state law.
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