5 Eyelids - Positional Problems

Question 1

involutional entropion

Answer 1

age related
orbital tissue atrophy
globe moves posteriorly

Question 2

congenital entropion

Answer 2

hypertrophy of orbicularis oculi

Question 3

epiblepharon

Answer 3

in young kids

improves w/ age

Question 4

cictricial entropion

Answer 4

palpebral conjunctiva scarring

Question 5

spastic entropion

Answer 5

trauma, surgery, blepharospasm

Question 6

blepharospasm

Answer 6

caffeine, fatigue

Question 7

entropion tx

Answer 7

temporary: drops, antibiotics, lid taping, bandage CL, epilation
long term: electrolysis, mucous membrane graft, surgery

Question 8

mechanical ectropion

Answer 8

heavy tumours pull lid down

Question 9

cicatricial ectropion

Answer 9

scarring/contracture of skin

accentuated by opening mouth

Question 10

paralytic ectropion

Answer 10

damage to CN VII
lack of tone of orbicularis
brow ptosis

Question 11

floppy eyyelid syndrome

Answer 11

rubbery upper lid

Question 12

ptosis

Answer 12

loss of fn of upper lid muscles

Question 13

congenital ptosis

Answer 13

dystrophy of levator muscle

Question 14

Marcus Gunn Jaw Winking syndrome

Answer 14

CN V fibres innervate CN III instead

improves with chewing

Question 15

3rd nerve misdirection syndromes

Answer 15

bizarre upper lid and various eye movements

Question 16

aponeurotic ptosis

Answer 16

good levator fn, thin eyelid above tarsal plate, deep upper sulcus

Question 17

3rd nerve palsy

Answer 17

only EOMs functioning are LR and SO = px’s eyes appear down and out
3rd nerve palsy with pupil involvement requires immediate MRI

Question 18

Horner syndrome

Answer 18

damage to ocular sympathethic nerve supply

triad on affected side: ptosis, miosis, anhydrosis

Question 19

myogenic ptosis

Answer 19

impaired muscle fn of levator

causes: myasthenia gravis, myotonic dystrophy, chronic progressive external ophthalmoplegia

Question 20

myotonic dystrophy

Answer 20

mournful facial expression, frontal baldness

Question 21

chronic progressive external ophthalmoplegia

Answer 21

gradual bilateral ocular immobility with no remission or exacerbation

Question 22

mechanical ptosis

Answer 22

impaired mobility of upper lid

Question 23

traumatic ptosis

Answer 23

trauma to levator m. or aponeurosis

Question 24

ptosis management

Answer 24

ptosis crutch, surgery

Question 25

pseudoptosis

Answer 25

lack of lid support by globe
contra lid retraction
ipsi hypotropia
brow ptosis
dermatochalasis
preseptal/orbital cellulitis

Question 26

preseptal cellulitis

Answer 26

non-life threatening
infection of subcut issues ant to orbital septum
normal vision, pupil, motility
antibiotics

Question 27

orbital cellulitis

Answer 27

life threatening
behind orb septum
fever, malaise, pain, reduced vision, proptosis, ophthalmoplegia
hopitalization, abtibiotics, blood tests, CT scan