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Eye Diseases
An overview of diseases affecting the eyes and vision, covering causes, symptoms, affected structures, diagnostic methods, treatment approaches and prognosis.
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An overview of diseases affecting the eyes and vision, covering causes, symptoms, affected structures, diagnostic methods, treatment approaches and prognosis.
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| # | TextNo. | TextDisease Name | TextCategory | TextPrimary Cause / Etiology | TextPrevalence | TextAge of Onset | TextKey Symptoms | TextAffected Organ(s) | TextDiagnostic Method | TextTreatment Approach | TextPrognosis | TextICD-10 Code |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 01 | 1 | Blepharitis (Anterior) | Eyelid, Lacrimal System & Ocular Surface Disorders | Chronic inflammation of the anterior eyelid margin involving lash follicles and glands of Zeis and Moll. Two main subtypes: staphylococcal (bacterial colonization, especially S. aureus and S. epidermidis producing exotoxins and lipases) and seborrheic (associated with seborrheic dermatitis and Malassezia species). Demodex mite infestation (D. folliculorum and D. brevis) increasingly recognized as contributor in 45-80% of blepharitis patients. Biofilm formation on lid margin perpetuates chronic inflammation. Often coexists with posterior blepharitis and dry eye disease. | One of the most common ocular conditions; estimated to affect 37-47% of all ophthalmology patients. Prevalence increases with age. Both sexes equally affected. Chronic relapsing condition present in up to 30% of general population. More common in patients with rosacea and seborrheic dermatitis. | Can occur at any age; prevalence increases with age, peaking in 5th-7th decade. Staphylococcal form more common in younger women. Seborrheic form increases with age. Demodex-related blepharitis more common after age 60 (100% colonization in elderly). | Burning, itching, and irritation of eyelid margins; crusting and flaking at base of lashes (collarettes in staphylococcal, greasy scales in seborrheic); eyelid erythema and swelling; madarosis (loss of lashes) in chronic cases; poliosis (whitening of lashes); trichiasis; chronic conjunctival injection; foreign body sensation; tearing; photophobia; fluctuating blurred vision from tear film instability; cylindrical dandruff at lash base (pathognomonic for Demodex). | Eyelid margins; lash follicles; conjunctiva; cornea (secondary keratitis in 25-30%) | Slit-lamp examination of lid margins showing collarettes, scales, telangiectasia, madarosis; assessment of lash follicles for Demodex (cylindrical dandruff); eyelid margin cultures if treatment-resistant; tear film assessment (TBUT, Schirmer test); evaluate for associated meibomian gland dysfunction, dry eye, and corneal involvement; Demodex count by lash epilation and microscopy (>3 mites per 4 lashes is significant). | Eyelid hygiene cornerstone: warm compresses (10 minutes twice daily), lid scrubs with dilute baby shampoo or commercial lid cleansers (Blephaclean, OCuSOFT). Topical antibiotic ointment: erythromycin 0.5% or bacitracin at bedtime for 2-4 weeks for staphylococcal form. Oral tetracycline derivatives (doxycycline 50-100mg daily for 6-12 weeks) for moderate-severe or rosacea-associated cases. Tea tree oil 50% lid scrubs or terpinen-4-ol for Demodex (twice daily for 6 weeks). Topical ivermectin 1% cream for Demodex. Intense pulsed light (IPL) therapy emerging for refractory cases. Artificial tears for concurrent dry eye. | Chronic relapsing condition requiring ongoing lid hygiene maintenance. Complete cure rare but symptoms controllable in 80-90% with consistent treatment. Exacerbations common during discontinuation of therapy. Complications include chalazia, corneal marginal infiltrates, phlyctenules, and madarosis. Long-term prognosis good for vision with appropriate management. Quality of life significantly impacted by chronic symptoms. | H01.001 |
| 02 | 2 | Blepharitis (Posterior/Meibomian) | Eyelid, Lacrimal System & Ocular Surface Disorders | Chronic inflammation of the posterior eyelid margin characterized by meibomian gland dysfunction (MGD) — obstruction and qualitative/quantitative changes in meibomian gland secretions (meibum). Meibomian glands produce the lipid layer of the tear film; dysfunction leads to evaporative dry eye. Obstructive MGD is most common form with keratinization of gland orifices and thickened meibum. Associated with rosacea (50-75% of rosacea patients have MGD), hormonal changes (androgen deficiency), contact lens wear, and aging. Chronic stasis of meibum promotes bacterial lipase activity and release of inflammatory free fatty acids. | Most common form of blepharitis; affects up to 70% of blepharitis patients. Prevalence of MGD estimated at 35-60% in Asian populations (higher prevalence) and 20-40% in Western populations. Prevalence increases significantly with age (75% in elderly). Accounts for approximately 86% of dry eye disease cases (evaporative dry eye). | Prevalence increases with age; uncommon before age 20. Most common in 5th-7th decade. Postmenopausal women at higher risk due to androgen deficiency. Contact lens wearers affected at younger ages. | Eyelid margin irregularity and thickening; capping or plugging of meibomian gland orifices with thick, opaque meibum; telangiectasia of lid margin; foamy tears (saponification of lipids); fluctuating blurred vision worse with prolonged visual tasks; burning and grittiness; foreign body sensation; rapid tear breakup time (<10 seconds); secondary corneal changes: inferior punctate epithelial erosions, marginal infiltrates, neovascularization in chronic cases; intermittent episodes of hordeola and chalazia. | Eyelid margins (meibomian glands); tear film (lipid layer deficiency); conjunctiva; cornea | Slit-lamp examination: inspect meibomian gland orifices, express meibum (assess quality — clear/cloudy/granular/toothpaste-like); non-contact meibography (infrared imaging of gland structure showing dropout/atrophy); tear film breakup time (TBUT <10 seconds); Schirmer test; interferometry (lipid layer thickness); LipiView tear interferometry; grading of MGD severity (1-4 scale); assess for associated rosacea, lid margin changes, and corneal staining. | Warm compresses (40-45°C for 10 minutes twice daily to melt obstructed meibum); lid massage after warm compresses to express glands; omega-3 fatty acid supplementation (EPA 1000mg + DHA 500mg daily — improves meibum quality); oral doxycycline 40-100mg daily for 6-12 weeks (anti-inflammatory, reduces lipase activity); azithromycin ophthalmic 1% for 3-day or monthly pulsed regimen; LipiFlow thermal pulsation system (vectored thermal pulsation, 42.5°C for 12 minutes — single treatment effective for 9-12 months); intense pulsed light (IPL) therapy; topical cyclosporine 0.05% or lifitegrast 5% for concurrent dry eye; punctal plugs if aqueous-deficient component. Probing of meibomian glands (intraductal probing) for severe obstruction. | Chronic progressive condition; meibomian gland atrophy is irreversible once advanced. Early treatment preserves gland function. LipiFlow shows sustained improvement at 12 months in 80% of patients. Warm compresses and lid hygiene provide symptom relief in 60-70% but require ongoing compliance. Dry eye symptoms are the primary long-term impact. Quality of life significantly affected. Visual prognosis good with consistent management but chronic discomfort common. | H01.009 |
| 03 | 3 | Blepharospasm | Eyelid, Lacrimal System & Ocular Surface Disorders | Involuntary bilateral forceful closure of the eyelids caused by spasms of the orbicularis oculi and periocular muscles. Benign essential blepharospasm (BEB) is an adult-onset focal dystonia of unknown cause involving basal ganglia dysfunction with loss of inhibition of the blink reflex. Secondary causes include Parkinson's disease, progressive supranuclear palsy, drug-induced (neuroleptics, levodopa), and reflex blepharospasm (from ocular surface irritation). Meige syndrome: blepharospasm combined with lower facial/oromandibular dystonia. Strongly associated with dry eye disease, photophobia, and stress. | Prevalence approximately 16-133 per million (estimated 20,000-50,000 affected in US). Female predominance (2-3:1). Mean age of onset 50-60 years. Incidence increases with age. Often underdiagnosed with average delay to diagnosis of 4-5 years. | Mean onset age 50-60 years. Rare before age 40. Slight female predominance (2-3:1). Symptoms worsen over first 5 years then typically stabilize. May be preceded by increased blinking for months to years. | Involuntary bilateral eyelid closure episodes (initially intermittent, progressing to sustained); increased blink rate and force; photophobia (90%); difficulty keeping eyes open for reading, driving, or watching television; functionally blind during severe spasms despite normal eye examination; exacerbating factors: bright lights, wind, stress, fatigue, driving, reading; alleviating factors: talking, singing, yawning, looking down; sensory tricks (geste antagoniste): touching face, wearing sunglasses; apraxia of eyelid opening (difficulty initiating voluntary opening after spasm subsides). | Orbicularis oculi and periocular muscles; basal ganglia (central nervous system dysfunction); bilateral | Clinical diagnosis based on characteristic bilateral involuntary eyelid closure episodes; absence of lower facial involvement differentiates from Meige syndrome; exclude reflex blepharospasm by treating underlying ocular surface disease; neurological examination to exclude secondary causes; brain MRI if atypical features or suspicion of secondary cause; dry eye assessment; jitter analysis and EMG of orbicularis rarely needed; response to botulinum toxin injection supports diagnosis. | Botulinum toxin type A injection (gold standard treatment): onabotulinumtoxinA (Botox) 2.5-5 units per injection site, typically 4-6 sites per eyelid (pretarsal and preseptal orbicularis); repeat every 3-4 months; effective in 85-95% of patients; incobotulinumtoxinA (Xeomin) and abobotulinumtoxinA (Dysport) are alternatives. Adjunctive measures: dark glasses/FL-41 tinted lenses for photophobia; treat concurrent dry eye disease; oral medications (benzodiazepines, trihexyphenidyl, baclofen) provide modest benefit in 30-40%. Myectomy (surgical removal of orbicularis muscle) for botulinum toxin-refractory cases (success 70-80%). Deep brain stimulation under investigation for severe refractory cases. | Chronic progressive condition that stabilizes after initial 5 years. Botulinum toxin provides sustained control in 85-95% with repeated injections. 10-15% of patients develop tolerance requiring dose adjustment. Spontaneous remission rare (<5%). Side effects of botulinum toxin: ptosis (5-15%), lagophthalmos, diplopia (temporary). Quality of life significantly impaired, especially driving and reading. Functional blindness from severe spasms despite normal visual acuity. With appropriate treatment, most patients achieve good functional control. | G24.5 |
| 04 | 4 | Chalazion | Eyelid, Lacrimal System & Ocular Surface Disorders | Chronic sterile lipogranulomatous inflammation of a meibomian gland caused by obstruction of the gland duct with retained meibum (lipid secretions) in surrounding tissue. Not an infection but a foreign body-type granulomatous reaction to extravasated lipid material. Histologically shows lipid-laden macrophages, multinucleated giant cells, and granulomatous inflammation. Associated with posterior blepharitis/MGD, rosacea, and seborrheic dermatitis. May develop from a resolved internal hordeolum. Recurrent chalazia should raise suspicion of sebaceous cell carcinoma (especially in elderly). | Very common; one of the most frequent eyelid conditions seen in clinical practice. Annual incidence estimated at 7-20 per 10,000 population. Affects all ages. More common in adults 30-50 years. Slightly more common in individuals with blepharitis, rosacea, and hyperlipidemia. | Most common in adults aged 30-50. Can occur at any age including children (peak 10-15 years in pediatric population). Recurrent chalazia more common in patients with chronic blepharitis and rosacea. Less common in elderly (reduced meibomian gland function). | Painless or mildly tender firm nodule within the eyelid (typically away from lid margin); eyelid swelling; cosmetic concern; upper lid involvement more common than lower (2:1 ratio reflecting more meibomian glands in upper lid); nodule ranges from 2-8mm; occasionally causes astigmatism if large and presses on cornea; may point and drain through conjunctival surface; chronic lesion has fibrous capsule; initial acute phase may mimic hordeolum with tenderness and erythema. | Eyelid (meibomian gland within tarsal plate); may press on cornea causing astigmatism | Clinical diagnosis based on characteristic firm eyelid nodule; slit-lamp examination to assess size, location, and relationship to lid margin; eversion of eyelid showing grey-red granulomatous tissue on tarsal conjunctiva; measure corneal astigmatism if large; recurrent or atypical lesions require biopsy to exclude sebaceous cell carcinoma (especially in elderly with unilateral recurrence, loss of lashes, or destruction of meibomian gland architecture). | Conservative management first (resolves 50% within 6 months): warm compresses (10-15 minutes 4 times daily), lid massage, and lid hygiene. Intralesional corticosteroid injection: triamcinolone acetonide 0.2-1.0mL of 5-40mg/mL into lesion through conjunctival surface (success rate 60-90% within 2 weeks; may repeat once). Incision and curettage (I&C) for persistent lesions (>4-6 weeks) or large chalazia: approach through conjunctival surface with chalazion clamp, vertical incision, curettage of granulomatous tissue (success rate >95%). Oral doxycycline 50-100mg daily for recurrent chalazia. Biopsy specimen for histopathology in recurrent cases to exclude malignancy. | Excellent prognosis. 25-50% resolve spontaneously with conservative measures. Intralesional steroid injection resolves 60-90%. Incision and curettage curative in >95%. Recurrence rate 5-10% at same site; higher with underlying MGD or rosacea. Complications rare: eyelid notching from surgery, skin depigmentation from steroid injection (especially darker skin). Sebaceous cell carcinoma must be excluded in recurrent or atypical cases. | H00.19 |
| 05 | 5 | Dacryoadenitis | Eyelid, Lacrimal System & Ocular Surface Disorders | Inflammation of the lacrimal gland (located in superolateral orbit). Acute dacryoadenitis: usually infectious — viral (most common in children: mumps, EBV, measles), bacterial (S. aureus, streptococci, N. gonorrhoeae), or rarely fungal. Chronic dacryoadenitis: autoimmune/inflammatory conditions — sarcoidosis (most common cause of bilateral chronic dacryoadenitis), IgG4-related disease, Sjogren syndrome, granulomatosis with polyangiitis (GPA), and lymphoma. Acute bacterial form rare in developed countries. Must distinguish from lacrimal gland tumors. | Acute: uncommon, exact incidence unknown. Chronic: varies with underlying cause. Sarcoidosis involves lacrimal gland in 15-28% of ocular sarcoidosis. IgG4-related disease is increasingly recognized cause. Lacrimal gland enlargement found in 25-50% of orbital inflammatory conditions. Overall relatively uncommon compared to other lacrimal pathology. | Acute viral: children and young adults (5-20 years, often associated with mumps). Acute bacterial: any age, more common in young adults. Chronic inflammatory: typically adults 30-60 years. IgG4-related disease: middle-aged to elderly males predominant. | Acute: rapid-onset unilateral (usually) pain, swelling, and erythema of superolateral eyelid; S-shaped ptosis (from lacrimal gland enlargement); tenderness over lacrimal gland; purulent discharge (bacterial); preauricular lymphadenopathy; fever and malaise. Chronic: painless bilateral (often) lacrimal gland enlargement; progressive swelling over weeks to months; dry eye symptoms (if gland function compromised); S-shaped lid contour; globe displacement inferonasally by enlarged gland. | Lacrimal gland; periorbital tissues; may involve salivary glands (systemic diseases like sarcoidosis, Sjogren, IgG4-related disease) | CT/MRI of orbits showing lacrimal gland enlargement (diffuse in inflammation, focal in tumor); distinguish from lacrimal gland tumors (tumors typically focal, may erode bone; inflammatory enlargement diffuse, molds to globe). Blood tests: CBC, ESR, CRP, ACE level (sarcoidosis), IgG4 levels, ANCA (GPA), ANA, SSA/SSB (Sjogren). Lacrimal gland biopsy if diagnosis uncertain (essential to exclude lymphoma). Chest X-ray for sarcoidosis. Viral serology in acute cases. | Acute infectious: warm compresses, oral antibiotics for bacterial (amoxicillin-clavulanate or ciprofloxacin for 10-14 days); viral — supportive care with NSAIDs. Chronic inflammatory: treat underlying disease — sarcoidosis: oral prednisone 40-60mg/day tapered over 2-4 months; IgG4-related disease: prednisone then steroid-sparing agents (rituximab, azathioprine); GPA: cyclophosphamide or rituximab; Sjogren: lubricants, pilocarpine 5mg three times daily. Lacrimal gland biopsy if lymphoma suspected. Orbital radiation for refractory inflammatory cases. | Acute viral dacryoadenitis: self-limiting with full recovery in 1-2 weeks. Acute bacterial: resolves with antibiotics, rare progression to abscess. Chronic inflammatory: prognosis depends on underlying disease. Sarcoidosis responds well to steroids but may recur. IgG4-related disease often chronic relapsing requiring long-term immunosuppression. Main concern is excluding lacrimal gland malignancy (pleomorphic adenoma or lymphoma), which requires biopsy. | H04.009 |
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