Ch30. Lagophthamos and other malpositions of the lid

Question 1

To which systemic condition is floppy Eyelid syndrome related?

Answer 1

To sleep apnea.

Question 2

Though related, just one of floppy eyelid syndrome and lid imbrication syndrome is related to giant papillary conjunctivitis, which one?

Answer 2

Floppy Eyelid syndrome.

Question 3

Which stains can aid in the diagnosis of lid imbrication syndrome?

Answer 3

Rose bengal and lissamine green can stain the abnormal tarsal conjunctiva.

Question 4

What gender predilection do lid imbrication syndrome and floppy eyelid syndrome have?

Answer 4

LIS: Female (2/3)

FES: Obese Male.

Question 5

Is testing for Bell’s phenomenon a good predictor of the actual globe position during sleep?

Answer 5

No.

_{Lyons CJ, McNab AA. Symptomatic nocturnal lagophthalmos. Aust NZ J Ophthalmol. 1990;18:393–396.}

_{Francis IC, Loughhead JA. Bell’s phenomenon. A study of 505 patients. Aust NZ J Ophthalmol. 1984;12:15–21.}

Question 6

If a patient presents with lagophthalmos, but the physical exam also indicates extraocular muscle hypofunction, other facial motility problems, and ptosis; which specific diagnosis should be ruled out?

Answer 6

myasthenia gravis, myotonic dystrophy, and chronic progressive external ophthalmoplegia

Question 7

If measured from the lower border of the brow to the palpebral margin, what is the minimal vertical dimension that allows for complete downward excursion and eyelid closure?

Answer 7

20mm

Question 8

In Which pathology can a patient have both, levator palpebralis hypofunction and lagophthalmos due to this muscle rigidity.

Answer 8

Congenital ptosis

Question 9

In which condition can lagophthalmos get worse during attempted closure?

Answer 9

Symblepharon

Symblepharon in the upper fornix can cause that the Bell’s phenomenon during attempted closure forces the lid to retract, and can worsen the lagophthalmos.

Question 10

What percentage of patients with bell’s paralysis experience orbicularis muscle function recovery?

Answer 10

75%