In part one of the skin series you learnt all about the basic structure of the skin and its role and functions. In part two, I’m going to shed some light on how skin structure can differ between sex and between ethnicity. Everybody’s skin is different and everybody deserves to know how they can look after it best.
Three weeks ago, I really badly burned my arm from steam, opening an oven door. It blistered, the skin was thick and bruised and my skin was raw. Three weeks later, the skin is smooth and soft, and the only trace of the burn is a slight difference in colour. In three weeks, my skin had completely re-built itself whilst fighting off infection successfully. And so, this blog post is the first in series dedicated to skin, the largest organ in our bodies. It’s a beautiful thing and you deserve to know what it is, how it works and how to care for it.
Anesthetics in Ophthalmic practice
reversible blockage of nerve fiber conduction (block sodium channels) Anesthetics in Ophthalmic Practice
祝大家新春愉快.平安喜樂. 金台診所於2月15日下午起至2月20日休診. 2月21日開始門診.
If you have been using nonprescription medicines to treat your symptoms for longer than 2 weeks, talk to your doctor. If you have gastroesophageal reflux disease (GERD), the stomach acid could be causing damage to your esophagus. Your doctor can help you find the right treatment. Making lifestyle changes is still an important part of the treatment of GERD when you are using medicine.
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Clinical stages of MGD with therapeutic options
✅ Stage 1 criteria and management
✍️ no symptoms
✍️ Minimally altered secretions
✍️ no ocular surface staining
✍️ Inform patient about MGD
✍️ management
• Alter diet
• reduce environmental stress
• Consider lid hygiene
• warm compresses and expressions
✅ Stage 2 criteria and management
✍️ Minimal to mild symptoms of discomfort, itching, and photophobia
✍️ Minimal to mild altered secretions
✍️ none or limited ocular surface staining and TFBUT( tear film break up time ) <10s
✍️ management
• Improve ambient humidity
• increase dietary omega-3 intake
• Lid hygiene and warm expression (minimum of 4min twice daily)
• Lubricants
• topical azithromycin
• liposomal spray
• Consider tetracycline derivatives
✅ Stage 3 criteria and management
✍️ Moderate symptoms with defnite limitation of activity
✍️ Moderately altered secretions
✍️ increased lid margin vascularity
✍️ telangiectasia
✍️ orifice plugging
✍️ Mild to moderate conjunctival and peripheral corneal staining
✍️ TFBUT around 5s
✍️ management as stage 2 Plus
• oral tetracycline derivatives
• Lubricant ointment
• Consider anti-inflammatory therapy for dry eye
✅ Stage 4 criteria and management
✍️ Marked symptoms with definite limitation of activity
✍️ Severely altered secretions with MG dropout
✍️ displacement Central corneal staining
✍️ conjunctival inflammation and hyperaemia
✍️ TFBUT < 5s
✍️ management the same As stage 3 treatment Plus
• anti-inflammatory therapy for dry eye
✅ MGD Plus-disease
✍️ Exacerbated inflammatory ocular disease surface disease
✍️ Mucosal keratinization
✍️ Phlyctenular keratitis
✍️ trichiasis
✍️ MG cysts or chalazion
✍️ Anterior blepharitis
✍️ management by all previously mentioned options with
• Pulsed steroid therapy
• therapeutic CL/scleral CL
• Epilation
• cryotherapy
• Intralesional steroid or excision
• topical antibiotic or antibiotic-steroid combination
• tea tree oil scrubs
