Diseases of the Eyelid and 3rd Eyelid Flashcards
What are the 4 layers of the eyelid?
Skin Muscle Tarsal plate Glands Conjunctiva
What are the 2 types of glands of the eyelid?
Cutaneous
Marginal
What are the 2 types of cutaneous glands of the eyelid?
Gland of zeis=sebaceous gland
Glands of Moll=modified sweat glands
What is the name & purpose of the marginal gland of the eyelid?
Meibomian/tarsal gland
-Adds lipid layer of tear film
What are the 3 sections of the conjunctiva and where are they located?
Palpebral-inside of eyelid
Bulbar-over sclera
Fornix- above where the other 2 types meet
What are types of cells are found on the conjunctiva that assist with lubrication?
Mucin producing goblet cells
Although there may be an eyelid disorder, dogs often present to you because of ______ & _____ signs.
Corneal & Conjunctival signs
What do dermoids, ankyloblepharons, and eyelid agenesis, all have in common?
They are all Congential eyelid disorders
Haired skin on surface of the eye=
Dermoid
-usually Lateral canthus
Fused eyelids=
ankyloblepharon
Infection of conjunctiva & cornea while eyelids are still fused=
Neonatal ophthalmia
What are is the main cause of Neonatal Opthalmia in Kittens? Puppies?
Kittens: Herpes!, Bacteria
Pups: Bacteria
What sequela of neonatal ophthalmia means the adhesion of conjunctiva to itself or the cornea?
Symblepharon
Is eyelid agenesis more common in Cats or Dogs?
Cats
Eyelid agenesis is often in which direction?
Dorsolateral
Which of the 3 congenital eyelid conditions are painful?
Eyelid agenesis
c/s= exposure keratitis & pain
Inward rolling of lids=
Entropion
Which type of Entropion is more common in dogs? cats?
Inherited-dogs
Acquired-cats
What are the different types of inherited entropion & what breeds are they seen in?
Medial-brachycephalics
Dorsolateral/Ventrolateral- giant breeds
Circumferential- Shar peis & chow chow
What can lead to spastic acquired entropion?
Chronic blepharospasm
What can lead to non-spastic acquired entropion?
Trauma or surgery
What 2 factors do the choice of entropion tx depend on?
Cause & Age
Spastic: Temporary tack mattress suture, +/- Hotz-celsus surgery
Congential/inherited
-Young: Temporary tack if
Eversion of the lower lid=
Ectropion
Dogs=common, cats=rare
What surgery can be used to treat Ectropion?
Full thickness V plasty-shortens lid
What should you recommend for an Ectropion case with concurrent entropion?
Ophthalmology referal!!
Lagophthalmos=
Can’t close eyes completely; sleep with eyes open
Euryblepharon=
Large palpebral fissue
I say
“Central pigmentary keratitis” you say:
Medial canthus syndrome in brachycephalics
-ie. nasal fold hair rubs on cornea
What are the 4 factors of Medial canthus syndrome in brachycephalics?
Euryblepharon
Lagophthalmos
Trichiasis/Distichiasis
Entropion
Medial canthus syndrome in brachycephalics tx=
Medial Canthoplasty(“eyelid tuck”)
What the difference between trichiasis & distichiasis?
Trichiasis=NORMAL hair touching cornea
Distichiasis= ABNORMAL hair touching cornea
What is difference between distichiasis & ectopic cilia?
Distichiasis=-Aberrant cilia from MEIBOMIAN gland openings
Ectopic cilia= Aberrant cilia from TARSAL gland grows through palpebral conjunctiva
What causes acute blepharospasm & a dorsal ellipitcal ulcer?
Ectopic cilia
-Dorsal elliptical ulcer= non-healing or recurrent corneal ulcer
T/F: If an eyelash is causing the dog issues, it’s best to just pluck it out.
FALSE!
Do NOT pluck lashes
What surgery technique can be used to treat districhiasis?
Electroeplilation
Blepharitis is characterized by:
Redness, discharge, Pruritis!
What should be given to a patient with blepharitis & and negative fluorescein stain?
Anti-inflammatories
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?
Chalazion(Meibomian cyst)
Lance it or Cryoepilation
What are the differences between a Chalazion and a Hordeolum/Stye?
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
What are the main bacterial causes of Hordeolums/styes?
Staph or strep
When treated an eyelid laceration that affects the margin, what is your main concern?
Must appose the eyelid margins PERFECTLY in alignment for proper eyelid function and tear film distribution
-If not perfect–>exposure keratits & trichiasis
What can be used on the corneal surface when cleaning an eyelid laceration?
Betadine-VERY VERY DILUTE(1:50)
What common eyelid tumor can cause conjunctivitis or keratitis if touching the cornea?
Meibomian gland adenoma
What is a uncommon eyelid tumor of young dogs?
Viral Papilloma
T/F: Eyelid tumors tend to be benign in dogs and malignant in cats.
True
What is the most common eyelid tumor found in cats?
SCC
What eyelid tumor is seen more in Persians & Himalayans?
Apocrine hidrocystoma
Removal of the gland of Nictitans may cause ______.
KCS
This disease of the 3rd eyelid, mostly found in retrievers & giant breed dogs
Scrolled cartilage of the 3rd eyelid
Acute appearance of the a red mass at the medial canthus=
Cherry eye-prolapsed nictitans GLAND
T/F: If a dog comes in with “Cherry eye”, a prolapsed nictitans gland, you should remove the gland.
FALSE!
DON’T remove the gland- predisposes to KCS
Replace the gland instead
Be sure to check the other gland!!
What systemic disease of cats can lead to protrusion of the 3rd eyelid?
Haws
Since they tend to look similar, how can you the difference between “Cherry eye” and TEL neoplasia?
Cherry eye
- Common
- Younger pets(
What is the ONLY indications for removing the nictitans gland?
TEL neoplasia
remove entire TEL, including the gland
