Disorders of Lashes

Question 1

The cilia pass between the ___ ___ and the muscle of _____ exiting the skin at the anterior lid margin and curve away from the globe.

Answer 1

oribularis oculi; Riolan

Question 2

_____ is a condition that may occur in isolation or as a result of scarring of the lid margin secondary to chronic bepharitis and herpes zoster opthalmicus.

Answer 2

Trichiasis

Question 3

What is trichinoses characterized by

Answer 3

posterior misdirection of lashes arising from normal sites of origin.

Question 4

How do you treat trichiasis

Answer 4

1. Epilation
2. Electrolysis
3. Cryotherapy
4. Argon laser ablation
5. Surgery

Question 5

____ with forceps is simple but recurrences within 4 weeks are inevitable. ____ is useful for a few isolated lashes but is tedious and may cause scarring and frequently multiple treatments are required to obtain a satisfactory result. ____ is effective in eliminating profuse lashes. Argon laser ablation is useful for a few scattered lashes. Surgery is useful for localized crop of lashes resistant to other methods of treatment

Answer 5

Epilation; Electrolysis; Cryotherapy

Question 6

What is congenital distichiasis

Answer 6

Rare condition that occurs when a primary epithelial germ cell destined to differentiate into a specialized sebaceous gland of the tarsus develops into a complete pilosebaceous unit. Majority of pts also manifest primary lymphedema of the legs.

Question 7

What are signs of congenital distichiasis

Answer 7

1. partial or complete second row of lashes emerging at/behind the the meibomian gland orifices.
2. Aberrant lashes tend to be thinner and shorter than normal cilia and are often directed posteriorly.

Question 8

Treatment of the lower lid is with ____.

Answer 8

cryotherapy.

Question 9

Acquired distichiases is caused by ____ and dedifferentiation of the _____ glands to become hair follicles. The most important cause is late stage cicatrizing _____ associated with chemical injury, Stevens johnson syndrome and ocular cicatricial pemphigoid.

Answer 9

metaplasia; meibomian; conjunctivitis.

Question 10

what are signs of acquired distichiases

Answer 10

1. variable number of lashes which originate from meibomian gland orifices.
2. cilia are non pigmented and stunted and symptomatic.

Question 11

what is eye lash ptosis associated with

Answer 11

floppy eyelid syndrome, dermatochalasis with anterior lamellar slip or long standing facial palsy.

Question 12

_____ refers to excessive eyelash growth

Answer 12

trichomegaly

Question 13

List the acquired causes of trichomegaly

Answer 13

1. drug induced - topical prostaglandin analogues phenytoin and cyclosporin
2. malnutrition
3. AIDS
4. Porphyria
5. Hypothyroidism
6. Familial

Question 14

What are congenital causes of trichomegaly

Answer 14

1. Oliver McFarlane syndrome: pigmentary retinopathy, dwarfism and mental handicap
2. Cornelia de Lange syndrome: mental and physical developmental abnormalities
3. Goldsten Hutt syndrome: cataract and hereidtary spherocystosis
4. Hermansky Pudlak syndrome: albinism and bleeding diathesis.

Question 15

_____ is a decrease in the number of lashes

Answer 15

madarosis

Question 16

what are local causes of madarosis

Answer 16

1. chronic anterior lid margin disease
2. infiltrating lid tumors
3. burns
4. radiotherapy/cyrotherapy of lid tumors

Question 17

which skin disorders cause madarosis

Answer 17

1. generalized alopecia

2. psoriasis

Question 18

which systemic diseases cause madarosis

Answer 18

1. myxoedema
2. systemic lupus erythematosus
3. acquired syphillis
4. lepromatous leprosy

Question 19

which are cases in following removal that cause madarosis

Answer 19

1. iatrogenic for trichiasis

2. trichotillomania- psychiatric disorder of hair removal.

Question 20

_____ is a premature localized whitening of hair, which may involve the lashes and eyebrows.

Answer 20

poliosis

Question 21

what are ocular causes of poliosis

Answer 21

1. chronic anterior blepharitis
2. sympathetic opthalmitis
3. idiopathic uveitis

Question 22

what are systemic causes of poliosis

Answer 22

1. vogt koyanagi harada syndrome
2. waardenburg syndrome
3. vitiligo
4. marfan syndrome
5. tuberous sclerosis

Question 23

acute allergic oedema is usually caused by ____ or by insect bites

Answer 23

pollen

Question 24

what are signs of oedema

Answer 24

sudden onset of bilateral pitting periorbital oedema, accompanied by conjunctival swelling (chemosis).

Question 25

contact dermatitis is an inflammatory response that usually follows exposure to a medication, presevarvites, cosmetics or metals. Reaction is mediated by delayed type ____ hypersensitivity response

Answer 25

IV

Question 26

Atopic dermatitis is a common idiopathic condition, associated with _____ and hay fever.

Answer 26

asthma

Question 27

What are signs of atopic dermatitis

Answer 27

thickening, crusting and vertical fissuring of the lids associated with staphylococcal blepharitis and madarosis.

Question 28

How do you treat atopic dermatitis

Answer 28

emollients to hydrate the skin and use mild topical steroids such as hydrocortisone .

Question 29

what are common ocular associations of atopic dermatitis

Answer 29

1. vernal disease in children and chronic keratoconjunctitivis in adults.

Question 30

what are uncommon ocular associations

Answer 30

keratoconus, presenile cataract and retinal detachment

Question 31

An external hordeolum is an acute staphylococcal abscess of a lash follicle and its associated gland of ______

Answer 31

Zeiss

Question 32

What are signs of an external hordeolum

Answer 32

a tender swelling in the lid margin pointing anteriorly through the skin, usually with a lash at the apex.

Question 33

how do you treat external hordeolum

Answer 33

involves topical antibiotics, hot compresses and epilation of the associated lash.

Question 34

what are signs of acute allergic oedema

Answer 34

1. lid oedema, scaling, angular fissuring and tightness. 2. chemosis, redness and papillary conjunctivitis. 3. punctate corneal epithelial erosions.

Question 35

how do you treat acute allergic oedema

Answer 35

1. stopping exposure to allergen. 2. use of non preserved drops 3. cold compresses 4. topical steroids 5. oral antihistamine

Question 36

______ is an uncommon superficial skin infection caused by _____ or _____ which mostly affects children

Answer 36

impetigo; staph aureus; staph pyogenes

Question 37

what are signs of impetigo

Answer 37

erythematous merciless rapidly developing into thin walled blisters which produce golden yellow crusts on rupturing.

Question 38

how do you treat impetigo

Answer 38

topical antibiotics and oral flucloxaciln or erythromycin.

Question 39

____ is an uncommon, acute subcutaneous spreading _____ caused by _____ through a site of minor skin trauma.

Answer 39

Erysipelas; cellultis; staph pryogenes

Question 40

what are signs of erysipelas, how do you treat it.

Answer 40

an expanding well defined, indurated, erythematous subcutaneous plaque. Treated with oral antibiotics.

Question 41

_____ fascitis is a rare rapidly progressive necrosis initially involving subcutaneous soft tissues and later the skin. It is caused by S. _____ and S. ____. the frequent sites of involvement are the extremities, trunk and perineum.

Answer 41

Necrotizing; pyogens; aureus.

Question 42

what are signs of necrotizing fascitis

Answer 42

periorbital redness and edema leading to formation of large bullae and black discoloration of skin due to gangrene secondary to underlying thrombosis

Question 43

____ _____ is a skin infection caused by human specific double stranded DNA poxvirus. Transmission is by contact and _____.

Answer 43

Molluscum contagiosum; autoinoculation

Question 44

what are signs of molluscum contagiosum

Answer 44

1. single or multiple pale, waxy, umbilicated nodules. 2. lesions on lid margin may shed virus into the tear film and give rise to a secondary ipsilateral chronic follicular conjuntivitis. 3. White cheesy material consisting of infected degenerate cells can be expressed form the lesion.

Question 45

How do you treat molluscum contagiosum

Answer 45

shave excision, cauterization, cryotherapy or laser.

Question 46

HZO presents with pain in the distribution of the first division of the ____ nerve. signs include a maculopapular rash on the forehead, progression through vesicles and pustules to crusting. It is treated with oral aciclovir or topical acyclovir & a steroid Ab combination

Answer 46

trigeminal

Question 47

What is the pathogenesis of Herpes simplex

Answer 47

primary infection or rarely reactivation of HS virus previously dormant in the trigeminal ganglion.