Cognition & Senses 2: Eyelids Flashcards by Nellie O'Leary

PALPEBRAE definition

= EYELIDS

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BLEPHARON definition

= EYELIDS

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ADNEXA definition

= TISSUES around the eye, including the LIDS & SKIN within 1 CM around the eye

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which MUSCLE in the eye is primarily involved in BLINKING?

what CRANIAL NERVE innervates it?

ORBICULARIS OCULI

innervated by FACIAL nerve (CN VII)

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animals tend to have CILIA only on…

THE UPPER EYELID

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name 3 functions of the EYELIDS?

PROTECTION of the eye & MAINTENANCE of OCULAR SURFACE HEALTH
BLINKING to ENTRAP/REMOVE DEBRIS & help with TEAR FILM DISTRIBUTION
GLANDULAR SECRETIONS of LIPID portion of the PRE-CORNEAL TEAR FILM to give NUTRITION to CORNEA & OCULAR SURFACE

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LAGOPHTHALMOS definition

this is seen frequently in WHAT BREEDS of dog?

INABILITY to CLOSE THE EYELIDS over the GLOBE OF THE EYE

frequent in SMALL BREEDS that have EXOPHTHALMOS

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MOST of the eyelid disease that we see is ___

SURGICAL

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how LONG does it take for EYES TO OPEN IN DOGS/CATS?

what if the lids open PREMATURELY?

what if the lids DO NOT OPEN? (name the term & clinical signs)

how LONG? = 10-14 days in DOGS/CATS

lids open PREMATURELY…
= DAMAGE TO THE OCULAR SURFACE

lids DO NOT OPEN = OPHTHALMIA NEONATORUM, causing CONJUNCTIVITIS/INFECTION

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in SMALL ANIMAL PRACTICE, we MAINLY see eye diseases that affect the ____ ____, which can result in ____ ____ disease, such as… (2)

EYELID MARGIN, OCULAR SURFACE disease, such as…
1. CORNEAL ULCERS
2. SCARRING

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what are the 4 main CATEGORIES of EYE DISEASE we’ll see in small animal practice?

EYELID MARGIN INTEGRITY
MEIBOMIAN GLANDS (tarsal glands)
PERIOCULAR SKIN
BLINKING

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4 most common DISEASES that COMPROMISE eyelid margin integrity

TRAUMA causing EYELID LACERATION (ex = running through bushes)
CONFORMATIONAL/BREED-RELATED from ENTROPION
EYELID NEOPLASMS
DEVELOPMENTAL abnormalities where PARTS OF EYELID ARE ABNORMAL or MISSING

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TRAUMA to the EYELIDS…

requires what 2 things? why?

what is the GOAL? why?

requires…
1. SURGERY
2. REPAIR ASAP

why? –> if the eye is left to heal on its own by SECONDARY INTENTION, could cause FIBROSIS & IRREGULAR EYELID MARGIN leading to OCULAR DZ

GOAL = to RESTORE SMOOTH EYELID MARGIN

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EYELID SURGERY…

how does the eye tend to heal? risk of infection?

what 4 things are REQUIRED to do the surgery?

how do PREP around the eye?

eye tends to heal QUICKLY due to GOOD BLOOD SUPPLY & LOW RISK OF INFECTION

what 4 things are REQUIRED to do the surgery?
1. good MAGNIFICATION 2-4 X
2. HIGH INTENSITY, FOCAL LIGHT
3. SMALL SUTURE often VICRYL (absorbable) or SILK (needs to be removed)
4. APPROPRIATE INSTRUMENTATION specific for eyelids

PREP = must use DILUTE BETADINE, we CANNOT USE ALCOHOL OR CHLORHEXIDINE because it can CAUSE A CORNEAL ULCER

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SURGICAL RESTORATION of EYELID MARGIN…

3 steps?

steps?
1. put SUTURE THROUGH MEIBOMIAN GLANDS in a FIGURE-8 SUTURE to KEEP KNOT AWAY FROM EYE

close the wound at eyelid margin in 2 LAYERS
use SIMPLE INTERRUPTED sutures to FINISH THE WOUND

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POST-OP CARE for EYELID SURGERY? (3)

if you use APPROPRIATE SURGICAL TECHNIQUE, MOST patients…

E-COLLAR for 14 DAYS (or until suture removal)
TOPICAL ANTIBIOTICS/ANTI-INFLAMMATORY (NeoPolyDex) for 14 DAYS
EXERCISE RESTRICTION for 1-2 WEEKS

if you use APPROPRIATE SURGICAL TECHNIQUE, MOST patients have a GOOD OUTCOME

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ENTROPION vs. ECTROPION?

what PART of the eyelid can be affected?

which one is MORE LIKELY to cause TEARING?

ENTROPION = eyelid margin ROLLING INTO EYE (more common)
–> MORE LIKELY TO CAUSE TEARING

ECTROPION = ROLLING OUT of the EYELID MARGIN

ONE or BOTH parts of the eyelid can be affected

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ID LESION

ENTROPION

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ID LESION

ECTROPION

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ENTROPION…

3 causes?

if you apply TOPICAL ANESTHESIA to the eye, WHICH of the causes will see RESOLUTION?

3 causes?
1. PRIMARY = common in SOME BREEDS
–> Shar Peis
–> Bulldogs

SPASTIC = CHRONIC SQUINTING causes EYE to be PULLED IN
CICATRICAL ENTROPION = from CHRONIC SPASTIC ENTROPION causing SCARRING TO EYE

if we give TOPICAL ANESTHESIA, then SPASTIC & CICATRICAL ENTROPION will be RESOLVED!

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BLEPHAROSPASM DEFINITION

SQUINTING

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EPIPHORA definition

when TEARS SPILL OVER THE LIDS from EXCESSIVE TEAR PRODUCTION

TRICHIASIS definition

= NORMAL HAIRS that are GROWING TOWARDS THE EYE & PUSHING ON IT

KERATITIS definition

if it’s LONG-TERM, can cause formation of ____ ____

= INFLAMMATION of the CORNEA

if it’s LONG-TERM, can cause formation of GRANULATION TISSUE

PTOSIS definition can sometimes SECONDARILY cause ___

= when the UPPER EYELID starts to SAG can can sometimes SECONDARILY cause TRICHIASIS (normal eyelashes touching surface of eye)

TREATMENT for ENTROPION... what 4 CLINICAL SIGNS do we need to address? treatment depends on... 3 options?

4 signs? 1. TRICHIASIS 2. PAIN 3. TEARING 4. CORNEAL IRRITATION treatment depends on the AGE of the ANIMAL / COMPLEXITY 3 options? 1. PUPPY = TEMPORARY TACK around the eye, sometimes FOLDS CAN EVEN OUT WITH AGE 2. if MILD = LUBRICATION BID to act as BARRIER between HAIRS & EYE SURFACE 3. if MODERATE to SEVERE = SURGERY

SURGERY for ENTROPION... we should choose the ___ TECHNIQUE to CORRECT THE PROBLEM most commonly we use WHAT technique? (2 names)

we should choose the SIMPLEST TECHNIQUE to CORRECT THE PROBLEM most commonly, we use the HOTZ-CELSUS or SMILE technique

HOTZ-CELSUS surgical technique... used to treat WHAT? 5 steps?

used to treat ENTROPION surgically steps? 1. STABILIZE LID 2. mark 2 LINES --> one a couple mm from EYELID MARGIN that spans LENGTH OF ENTROPION --> another HOW FAR YOU WANT TO ROLL OUT THE LID 3. make 2 INCISIONS with a BLADE at MARK 4. REMOVE SKIN ONLY with SCISSORS 5. close with ONE LAYER of SUTURE

EYELID NEOPLASMS... commonality? diffuse vs. focal? often originates from the ___ ___ & causes SECONDARY ___ from... MOST of what we see are ____ _____ _____ in DOGS CATS vs. DOGS?

VERY COMMON usually FOCAL often originates from the MEIBOMIAN GLAND & causes SECONDARY CHELAZIAN from SECONDARY SWELLING OF GLAND bc LIPID PRODUCT CANNOT ESCAPE MOST of what we see are MEIBOMIAN GLAND ADENOMAS in DOGS DOGS = usually BENIGN CATS = often AGGRESSIVE

what EYELID NEOPLASMS can we commonly see in CATS? (2)

1. SQUAMOUS CELL CARCINOMA 2. MAST CELL TUMORS

ID LESION

MEIBOMIAN GLAND ADENOMA

TREATMENT for EYELID NEOPLASM... depends on... (3) ___ is usually required

depends on... 1. CLINICAL SIGNS --> is it bothering the pet? 2. TUMOR TYPE 3. COST of tx SURGERY is USUALLY REQUIRED

ID LESION (2 possibilities) what is the PROGNOSIS for this? common in WHAT AGE dogs?

HISTIOCYTOMA or PAPILLOMA prognosis is GOOD, these USUALLY REGRESS common in YOUNG DOGS

SURGERY for SMALL EYELID TUMOR... usually perform a ____ ____ 4 steps? what is ONE REQUIREMENT to even do this procedure? --> what do we need to do?

usually perform a WEDGE RESECTION steps? 1. make 2 INCISIONS on EITHER SIDE OF MASS at RIGHT ANGLES TO LID MARGIN 2. make a HOUSE-SHAPED INCISION so that LOWER-LID DOES NOT PUCKER 3. close in 2 LAYERS with 4-0 to 6-0 VICRYL (WEDGE and FIGURE OF 8) 4. submit for PATHOLOGY the MASS must be <1/3 EYELID MARGIN LENGTH or else WILL NOT BE ABLE TO CLOSE EYE UPON REMOVAL --> we need to MEASURE BEFOREHAND

TREATMENT for LARGE EYELID TUMOR... = define WHAT a large eyelid tumor is what DIAGNOSTIC procedure can we perform? if we need to treat SURGICALLY...

= >1/3 EYELID LENGTH diagnostic? = FNA if POSSIBLE! if we need to treat SURGICALLY, might need RECONSTRUCTIVE PROCEDURE/SKIN GRAFT, so REFER OUT!

EYELID AGENESIS... "aka?" = definition & etiology common in WHAT species? causes what 3 clinical signs? 2 treatment goals?

aka "COLOBOMA" = INCOMPLETE LATERAL UPPER EYELID MARGIN & CONJUNCTIVA that has CONGENITAL ORIGIN 3 clinical signs.. 1. TRICHIASIS 2. TEARING 3. CHRONIC EXPOSURE KERATITIS 2 treatment goals? 1. RESOLVE TRICHIASIS 2. create SMOOTH EYELID MARGIN

ID DZ (2 names)

EYELID AGENESIS / COLOBOMA

what is the SURGICAL TREATMENT for EYELID AGENESIS / COLOBOMA? what can be CHALLENGING about treating this?

use ROTATIONAL SKIN FLAPS to move SKIN FROM BELOW to TOP TO RECREATE EYELID MARGIN difficult to RESTORE INTEGRITY OF EYELID MARGIN (close tightly)

DERMOID... = definition commonality? tx?

= HAIR GROWING in ABNORMAL PLACE UNCOMMON tx = SURGICAL RESECTION

ID LESION

DERMOID

DISTICHIASIS = definition commonality? unilateral vs. bilateral? 3 clinical signs?

= ABERRANT CILIA that GROW from the MEIBOMIAN GLANDS due to ABNORMAL DEVELOPMENT COMMON usually BILATERAL 3 clinical signs? 1. INCREASED BLINKING 2. BLEPHAROSPASM (squinting) 3. TEARING

ID LESION & define

DISTICHIASIS ABERRANT CILIA grow out of MEIBOMIAN GLANDS

ID LESION

DISTICHIA

ECTOPIC CILIA... = definition commonly also have WHAT secondary condition? 2 clinical signs? 1 signalment?

= CILIA that emerge THROUGH PALPEBRAL CONJUNCTIVA to TOUCH CORNEA commonly also have DISTICHIASIS 2 clinical signs? 1. PAINFUL EYE 2. RECURRENT CORNEAL ULCERS 1 signalment = YOUNG DOGS

TREATMENT for DISTICHIASIS... most commonly? what is the procedure? 2 benefits? 2 risks? both are +/-

MOST COMMONLY = use CRYOTHERAPY to FREEZE MEIBOMIAN GLAND & DESTROY FOLLICLE 2 benefits? 1. SPARES the NORMAL tissue 2. PRESERVES EYELID MARGIN 2 risk? +/- DEPIGMENTATION +/- REGROWTH of hairs, but usually come back SOFTER

TREATMENT for ECTOPIC CILIA? (2)

1. EXCISE the ABERRANT HAIRS 2. use CRYOTHERAPY to REMOVE

CHALAZION... = definition 2 common etiologies? 2 treatment options?

= LIPID in the MEIBOMIAN GLAND causing INFLAMMATION 2 common etiologies? 1. ATOPY (allergy) 2. EYELID TUMORS that are BLOCKING EXIT OF LIPID SECRETIONS treatment? 1. WEDGE RESECTION to remove 2. use BLADE to EXCISE then CRYOTHERAPY

ID LESION

CHALAZION

BLEPHARITIS = definition causes WHAT 4 CLINICAL SIGNS? clinical approach? (overall and 4 subs) surgery?

= ANY SWELLING of EYELIDS 4 signs? 1. MARKED LID HYPEREMIA & EDEMA 2. PAIN 3. TEARING 4. SELF-TRAUMA (alopecia, erosions) clinical approach? = DIAGNOSTICS to DETERMINE CAUSE, so CLIP & CLEAN then... 1. SKIN SCRAPE 2. C&S 3. CYTOLOGY 4. TRICHOGRAM NO SURGERY

ID CLINICAL SIGN

BLEPHARITIS

7 possible ETIOLOGIES for BLEPHARITIS?

1. BACTERIAL infection 2. SEBACEOUS OVERPRODUCTION 3. DEMODEX & SCABIES 4. IMMUNE-MEDIATED 5. DRUG RXN 6. FOOD ALLERGY 7. ACTINIC KERATOSIS (sun-related injury)

PUPPY STRANGLES.. aka? = definition 3 tx? if this is NOT RESOLVED... common in WHAT patients? with WHAT?

aka BACTERIAL BLEPHARITIS = STAPHYLOCOCCAL INFECTION around the EYELID 3 tx? 1. ANTIBIOTICS 2. ORAL PREDNISONE 3. TOPICAL ANTIBIOTICS & ANTI-INFLAMMATORIES via EYE DROPS if NOT RESOLVED, can cause CICATRICAL ENTROPION from EYELID DISTORTION common in WHITE FLUFFY DOGS with ATOPY

SURGICAL TREATMENT for ____ BREED with LAGOPHTHALMOS? (3 words, & define what it does) is this always done?

BRACHYCEPHALIC BREED = PERMANENT MEDIAL CANTHOPLASTY, helps to MAKE THE MEDIAL EYELID SMALLER NOT ALWAYS DONE, can try LUBRICATING EYE REGULARLY