Diseases of the Eyelid and 3rd Eyelid

Question 1

What are the 4 layers of the eyelid?

Answer 1

Skin
Muscle
Tarsal plate
Glands
Conjunctiva

Question 2

What are the 2 types of glands of the eyelid?

Answer 2

Cutaneous

Marginal

Question 3

What are the 2 types of cutaneous glands of the eyelid?

Answer 3

Gland of zeis=sebaceous gland

Glands of Moll=modified sweat glands

Question 4

What is the name & purpose of the marginal gland of the eyelid?

Answer 4

Meibomian/tarsal gland

-Adds lipid layer of tear film

Question 5

What are the 3 sections of the conjunctiva and where are they located?

Answer 5

Palpebral-inside of eyelid

Bulbar-over sclera

Fornix- above where the other 2 types meet

Question 6

What are types of cells are found on the conjunctiva that assist with lubrication?

Answer 6

Mucin producing goblet cells

Question 7

Although there may be an eyelid disorder, dogs often present to you because of ______ & _____ signs.

Answer 7

Corneal & Conjunctival signs

Question 8

What do dermoids, ankyloblepharons, and eyelid agenesis, all have in common?

Answer 8

They are all Congential eyelid disorders

Question 9

Haired skin on surface of the eye=

Answer 9

Dermoid

-usually Lateral canthus

Question 10

Fused eyelids=

Answer 10

ankyloblepharon

Question 11

Infection of conjunctiva & cornea while eyelids are still fused=

Answer 11

Neonatal ophthalmia

Question 12

What are is the main cause of Neonatal Opthalmia in Kittens? Puppies?

Answer 12

Kittens: Herpes!, Bacteria

Pups: Bacteria

Question 13

What sequela of neonatal ophthalmia means the adhesion of conjunctiva to itself or the cornea?

Answer 13

Symblepharon

Question 14

Is eyelid agenesis more common in Cats or Dogs?

Answer 14

Cats

Question 15

Eyelid agenesis is often in which direction?

Answer 15

Dorsolateral

Question 16

Which of the 3 congenital eyelid conditions are painful?

Answer 16

Eyelid agenesis

c/s= exposure keratitis & pain

Question 17

Inward rolling of lids=

Answer 17

Entropion

Question 18

Which type of Entropion is more common in dogs? cats?

Answer 18

Inherited-dogs

Acquired-cats

Question 19

What are the different types of inherited entropion & what breeds are they seen in?

Answer 19

Medial-brachycephalics

Dorsolateral/Ventrolateral- giant breeds

Circumferential- Shar peis & chow chow

Question 20

What can lead to spastic acquired entropion?

Answer 20

Chronic blepharospasm

Question 21

What can lead to non-spastic acquired entropion?

Answer 21

Trauma or surgery

Question 22

What 2 factors do the choice of entropion tx depend on?

Answer 22

Cause & Age

Spastic: Temporary tack mattress suture, +/- Hotz-celsus surgery

Congential/inherited
-Young: Temporary tack if

Question 23

Eversion of the lower lid=

Answer 23

Ectropion

Dogs=common, cats=rare

Question 24

What surgery can be used to treat Ectropion?

Answer 24

Full thickness V plasty-shortens lid

Question 25

What should you recommend for an Ectropion case with concurrent entropion?

Answer 25

Ophthalmology referal!!

Question 26

Lagophthalmos=

Answer 26

Can't close eyes completely; sleep with eyes open

Question 27

Euryblepharon=

Answer 27

Large palpebral fissue

Question 28

I say | "Central pigmentary keratitis" you say:

Answer 28

Medial canthus syndrome in brachycephalics -ie. nasal fold hair rubs on cornea

Question 29

What are the 4 factors of Medial canthus syndrome in brachycephalics?

Answer 29

Euryblepharon Lagophthalmos Trichiasis/Distichiasis Entropion

Question 30

Medial canthus syndrome in brachycephalics tx=

Answer 30

Medial Canthoplasty("eyelid tuck")

Question 31

What the difference between trichiasis & distichiasis?

Answer 31

Trichiasis=NORMAL hair touching cornea Distichiasis= ABNORMAL hair touching cornea

Question 32

What is difference between distichiasis & ectopic cilia?

Answer 32

Distichiasis=-Aberrant cilia from MEIBOMIAN gland openings Ectopic cilia= Aberrant cilia from TARSAL gland grows through palpebral conjunctiva

Question 33

What causes acute blepharospasm & a dorsal ellipitcal ulcer?

Answer 33

Ectopic cilia -Dorsal elliptical ulcer= non-healing or recurrent corneal ulcer

Question 34

T/F: If an eyelash is causing the dog issues, it's best to just pluck it out.

Answer 34

FALSE! Do NOT pluck lashes

Question 35

What surgery technique can be used to treat districhiasis?

Answer 35

Electroeplilation

Question 36

Blepharitis is characterized by:

Answer 36

Redness, discharge, Pruritis!

Question 37

What should be given to a patient with blepharitis & and negative fluorescein stain?

Answer 37

Anti-inflammatories

Question 38

A dog comes in for a pea-like swelling on the inside of the upper eyelid. Although it does not appear painful, the owner is concerned since it sometimes leaks yellow-white caseous material. What is your top ddx and how would you treat this?

Answer 38

Chalazion(Meibomian cyst) Lance it or Cryoepilation

Question 39

What are the differences between a Chalazion and a Hordeolum/Stye?

Answer 39

Chalazion - Meibomian CYST - NON painful - CASEOUS d/c - Come to head on INSIDE of lid - SURGERY is the treatment(if it's enlarged & causing discomfort) Hordeolum/Stye - Meibomian or Skin gland(Moll, Zeis) INFECTION - PAINFUL - PURULENT d/c - Comes to head on OUTSIDE of lid - RARELY needs surgery: treated w/ local warm packs, topical anti-inflammatories & antibiotics

Question 40

What are the main bacterial causes of Hordeolums/styes?

Answer 40

Staph or strep

Question 41

When treated an eyelid laceration that affects the margin, what is your main concern?

Answer 41

Must appose the eyelid margins PERFECTLY in alignment for proper eyelid function and tear film distribution -If not perfect-->exposure keratits & trichiasis

Question 42

What can be used on the corneal surface when cleaning an eyelid laceration?

Answer 42

Betadine-VERY VERY DILUTE(1:50)

Question 43

What common eyelid tumor can cause conjunctivitis or keratitis if touching the cornea?

Answer 43

Meibomian gland adenoma

Question 44

What is a uncommon eyelid tumor of young dogs?

Answer 44

Viral Papilloma

Question 45

T/F: Eyelid tumors tend to be benign in dogs and malignant in cats.

Answer 45

True

Question 46

What is the most common eyelid tumor found in cats?

Answer 46

SCC

Question 47

What eyelid tumor is seen more in Persians & Himalayans?

Answer 47

Apocrine hidrocystoma

Question 48

Removal of the gland of Nictitans may cause ______.

Answer 48

KCS

Question 49

This disease of the 3rd eyelid, mostly found in retrievers & giant breed dogs

Answer 49

Scrolled cartilage of the 3rd eyelid

Question 50

Acute appearance of the a red mass at the medial canthus=

Answer 50

Cherry eye-prolapsed nictitans GLAND

Question 51

T/F: If a dog comes in with "Cherry eye", a prolapsed nictitans gland, you should remove the gland.

Answer 51

FALSE! DON'T remove the gland- predisposes to KCS Replace the gland instead Be sure to check the other gland!!

Question 52

What systemic disease of cats can lead to protrusion of the 3rd eyelid?

Answer 52

Haws

Question 53

Since they tend to look similar, how can you the difference between "Cherry eye" and TEL neoplasia?

Answer 53

Cherry eye - Common - Younger pets(

Question 54

What is the ONLY indications for removing the nictitans gland?

Answer 54

TEL neoplasia remove entire TEL, including the gland