15.4 KHURANA EYELASH DISORDERS, LID MARGINS POSITION Flashcards
It refers to inward misdirection of cilia (which rub against the eyeball) with normal position of the lid margin
- TRICHIASIS
- DISTICHIASIS
- MADAROSIS
TRICHIASIS
partial or complete loss of eyelashes.
- TRICHIASIS
- DISTICHIASIS
- MADAROSIS
MADAROSIS
is a rare anomaly in which an extra row of cilia occupies the position of Meibomian glands which open into their follicles as ordinary sebaceous glands.
- Congenital distichiasis
- Acquired distichiasis
Congenital distichiasis
(metaplastic lashes) occurs when due to metaplasia and differentiation, the meibomian glands are transformed into hair follicles.
- Congenital distichiasis
- Acquired distichiasis
Acquired distichiasis
extra row of cilia
- TRICHIASIS
- DISTICHIASIS
- MADAROSIS
DISTICHIASIS
Seen more commonly in lower than upper eyelid.
- Congenital entropion
- Cicatricial entropion
Congenital entropion
It is a common variety usually involving the upper lid.
- Congenital entropion
- Cicatricial entropion
Cicatricial entropion
is usually secondary to mechanical effects of microphthalmos.
- Upper eyelid congenital entropion
- Lower eyelid congenital entropion
Upper eyelid congenital entropion
is caused by improper development of the lower lid retractors
- Upper eyelid congenital entropion
- Lower eyelid congenital entropion
Lower eyelid congenital entropion
It is common occurrence and affects only the lower lid in elder people
- Senile (involutional) entropion
- Mechanical entropion.
Senile (involutional) entropion
It occurs due to lack of support provided by the globe to the lids.
- Senile (involutional) entropion
- Mechanical entropion.
Mechanical entropion
due to weakening of orbicularis muscle
- Horizontal laxity of the lid
- Vertical lid instability
Horizontal laxity of the lid
due to weakening or dehiscence of capsulopalpebral fascia (lower lid retractor)
- Horizontal laxity of the lid
- Vertical lid instability
Vertical lid instability
MATCH THE FF:
- includes inturning up to the inter-marginal strip
- in which the whole lid margin including the anterior border is inturned
- only the posterior lid border is inrolled
a. Grade I entropion
b. Grade II entropion
c. Grade III entropion
- b. Grade II entropion
- c. Grade III entropion
- a. Grade I entropion
may resolve with time without need of any intervention or may require excision of a strip of skin and muscle with plastic reconstruction of the lid crease (Hotz procedure)
- Congenital Entropion
- Cicatricial Entropion
Congenital Entropion
It is treated by a plastic operation, which is based on any of the following basic principles:
• Altering the direction of lashes, or
• Transplanting the lashes, or
• Straightening the distorted tarsus.
- Congenital Entropion
- Cicatricial Entropion
Cicatricial Entropion
It is the simplest operation employed to correct mild degree of entropion.
- Anterior lamellar resection
- Tarsal wedge resection
Anterior lamellar resection
It corrects moderate degree of entropion associated with atrophic tarsus. In this operation, in addition to the elliptical resection of skin
- Anterior lamellar resection
- Tarsal wedge resection
Tarsal wedge resection
This is indicated to treat mild to moderate amount of cicatricial entropion. It basically involves tarsal fracture and eversion of distal tarsus.
- Transposition of tarsoconjunctival wedge
- Posterior lamellar graft
Transposition of tarsoconjunctival wedge
Indications of this operation include severe entropion with upper eyelid retraction.
- Transposition of tarsoconjunctival wedge
- Posterior lamellar graft
Posterior lamellar graft
Out rolling or outward turning of the lid margin
- ECTROPION
- SYMBLEPHARON
ECTROPION
“outward turn”
In this condition, lids become adherent with the eyeball as a result of adhesions between the palpebral and bulbar conjunctiva.
- ECTROPION
- SYMBLEPHARON
SYMBLEPHARON
“adhesion bet. palpebral and bulbar conjunctiva”
This is very rare, but may be seen in Down syndrome and blepharophimosis syndrome.
- Congenital ectropion
- Involutional ectropion
Congenital ectropion
It is the commonest variety and involves only the lower lids. It occurs due to following age-related changes: • Horizontal laxity of eyelid, • Medial canthal tendon laxity, • Lateral canthal tendon laxity, and • Disinsertion of lower lid retractors.
- Congenital ectropion
- Involutional ectropion
Involutional ectropion
“age-related changes”
It occurs due to scarring of the skin and can involve both the lids.
- Cicatricial ectropion
- Paralytic ectropion
- Mechanical ectropion
Cicatricial ectropion
“scarring of the skin”
It results due to paralysis of the seventh nerve. It mainly occurs in the lower lids.
- Cicatricial ectropion
- Paralytic ectropion
- Mechanical ectropion
Paralytic ectropion
“paralysis of 7th nerve”
It occurs in conditions where either the lower lid is pulled down (as in tumours) or pushed out and down (as in proptosis and marked chemosis of the conjunctiva).
- Cicatricial ectropion
- Paralytic ectropion
- Mechanical ectropion
Mechanical ectropion
“pulled down”
LID MARGIN IS OUTROLLED.
- The fornix is also visible.
- Lid margin is everted and palpebral conjunctiva is visible.
- In it only punctum is everted.
- Grade I
- Grade II
- Grade III
- Grade III
- Grade II
- Grade I
Grade I: In it only punctum is everted.
Grade II: Lid margin is everted and palpebral
conjunctiva is visible.
Grade III: The fornix is also visible.
Paralytic ectropion results due to paralysis of the _________
- third cranial nerve
- seventh cranial nerve
seventh cranial nerve
This happens when a tumor or other mass in your eyelid pulls the eyelid down.
- Cicatricial ectropion
- Paralytic ectropion
- Mechanical ectropion
Mechanical ectropion
“eyelid down”
It results from healing of the kissing raw surfaces upon the palpebral and bulbar conjunctiva.
- ECTROPION
- SYMBLEPHARON
SYMBLEPHARON
Common causes are thermal or chemical burns, membranous conjunctivitis, injuries, conjunctival ulcerations, ocular pemphigus and Stevens-Johnson syndrome.
- ECTROPION
- SYMBLEPHARON
SYMBLEPHARON
may be experienced due to restricted ocular motility
- Diplopia
- Lagophthalmos
Diplopia
inability to close the lids may occur due to adhesions
- Diplopia
- Lagophthalmos
Lagophthalmos
adhesions present only in the anterior part
- Anterior symblepharon
- Posterior symblepharon
- Total symblepharon
Anterior symblepharon
adhesions present in the fornices
- Anterior symblepharon
- Posterior symblepharon
- Total symblepharon
Posterior symblepharon
adhesions involving whole of the lid
- Anterior symblepharon
- Posterior symblepharon
- Total symblepharon
Total symblepharon
It refers to the adhesions between margins of the upper and lower lids
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
ANKYLOBLEPHARON
It is usually associated with symblepharon.
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
ANKYLOBLEPHARON
In this condition the extent of the palpebral fissure is decreased. It appears contracted at the outer canthus.
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
BLEPHAROPHIMOSIS
a congenital anomaly in which the eyelids are underdeveloped such that they cannot open as far as usual and permanently cover part of the eyes.
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
BLEPHAROPHIMOSIS
This condition is characterised by inability to close the eyelids voluntarily.
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
LAGOPHTHALMOS
It is characterised by incomplete closure of the palpebral aperture associated with features of the causative disease.
- ANKYLOBLEPHARON
- BLEPHAROPHIMOSIS
- LAGOPHTHALMOS
LAGOPHTHALMOS
It refers to the involuntary, sustained and forceful closure of the eyelids.
- BLEPHAROSPASM
- PTOSIS
BLEPHAROSPASM
It is a rare idiopathic condition involving patients between 45 and 65 years of age.
- Essential (spontaneous) blepharospasm
- Reflex blepharospasm
Essential (spontaneous) blepharospasm
It usually occurs due to reflex sensory stimulation through branches of fifth nerve (trigeminal)
- Essential (spontaneous) blepharospasm
- Reflex blepharospasm
Reflex blepharospasm
Abnormal drooping of the upper eyelid
- BLEPHAROSPASM
- PTOSIS
- LID RETRACTION
PTOSIS
It is associated with congenital weakness (maldevelopment) of the levator palpebrae superioris (LPS).
- BLEPHAROSPASM
- PTOSIS
- LID RETRACTION
PTOSIS
Normally, the upper eyelid covers 1/6th of the cornea (about 2 mm). ______ is labelled when the lid margin is either at or above the level of superior limbus.
- BLEPHAROSPASM
- PTOSIS
- LID RETRACTION
LID RETRACTION