Aesthetics

Question 1

Describe Schirmers test?

Answer 1

Schirmers test assesses tear production/dry eyes
- topical anaesthetic drops applied
- 35x5mm strip of filter paper placed on lower lid
- excursion of tears along filter paper measured at 5mins
>10mm normal

Question 2

Examination for blepharoplasty

Answer 2

LOOK:

1. Front
   Skin type/texture
   General facial harmony
   Forehead ?transverse rhytids (static v dynamic)
   Brow position & symmetry
   Eyes ?lateral crows feet (static v dynamic)
   - Upper - ?dermatochalasis, ?hooding, ?fat herniation
   - Lower - ?ectropion, ?scleral show ?dermatochalasis, ?orbital festoons, ?malar bags, ?tear trough deformity
2. Side
   Vector ?negative/positive

FEEL/MOVE
Palpate brow ?level of supra orbital margin
Compensated brow ptosis
- close eyes ?note eyebrows drop/frontalis relaxes
- fix eyebrows at orbital rim and reopen eyes ?greater degree of ptosis
Palpate globe ?fat pad herniation
Snap test
Medial/lateral canthal laxity
Bells phenomenon

OTHER
Full opthalmic review (within last 6/12) incl visual acuity/visual fields and Schirmers test if history of dry eyes