eyelid and conjunctiva Flashcards
what is the ocular adnexa ?
is a collective term for ocular appendages
. eyelids
. conjunctiva
. lacrimal system
what is the lacrimal system responsible for ?
- tear production and tear drainage
- protective/supportive role
- maintaining clarity of cornea and contributing to the protection of the ocular surface
what is the position of the eye within the orbit ?
- the eye tends to adopt an anterior position
- eyes adopt a relatively forward position and protruding beyond the lateral margins of the orbit
what are the two parts of the eyelid ?
- orbital part which sits just below the eyebrow
- tarsal part - contains the tarsal plate
what happens to the folds around the eye ?
- they become more pronounced with age
what are the two predominant folds of the eye ?
- superior palpebral sulcus - top of tarsal plate - where upper eyelid folds - represents the separation between the orbital and the tarsal part
- inferior palpebral sulcus
. below that marks the borders of the orbital cavity - we have lateral fold ( Malar sulcus ) and one medially on the nasal side ( nasojugal sulcus )
what is the space between eyelids ?
palpebral aperture
what are the two angles of the eye where the two eyelids meet laterally and medially ?
- outer canthus - lateral point - at which the two eyelids come together
- inner canthus - equivalent on the medial side
what is one of the features of inner canthus ?
presence of these two structures
- plica semilunaris - sits lateral to the caruncle - fold of mucosa
- caruncle - mound of mucosal tissue that sits most medially
what is conjunctiva ?
mucous membrane which both lines back surface of the eyelid and covers the white of the eye up to its junction with the cornea which is known as the limbus
what is the limbus ?
term we use for the junction between cornea and sclera
what is arising from the anterior border of both eyelids ?
eyelashes - we can see two or three rows of eyelashes that emanate from anterior border of both eyelids
what is caruncle ?
- mound of mucosal tissue
- contains a lot of goblet cells but doesn’t have any specific function
what are the eyelids ?
the eyelids are two moveable folds of the skin
what is the function of eyelids ?
- they are largely their for protection
- they serve several important functions
1. acting as occluders shielding the eyes from excessive light
e. g. when looking at the sun
- blink reflex affords protection against injury
what is the purpose of periodic blinking ?
- the purpose of periodic blinking is the spreading of the tear layer
- forms a tear film of uniform thickness during the upturn phase of each blink
- blinking is important for tear drainage
how many times do we blink per minute ?
10-12 times per minute
what is difference between upper and lower eyelid ?
- upper eyelid is larger and more mobile
- lower eyelids displays a medial movement during blinking - moves laterally rather than up and down
how many rows of lashes emerge from the anterior border of the lid margins ?
- 2-3 rows of lashes emerge from the anterior border of the margins
what does eyelid position alter with ?
- eyelid position alters with eye gaze
- close coordination between eye movement and lid position
what happens when we look upward ?
- the upper eyelid is retracted so that increases the field of view in the up case
what happens when we look downwards?
- the lower eyelids retracts and pulls down - which increase field of view in lower field vision
where are meibomian gland opening ?
- meibomian gland openings are (30-40) located along the lid margins - which sit in upper and lower eyelid
- located just anterior to the mucocutaneous junction
what is the junction between eyelid skin and conjunctiva ?
mucocutaneous junction
what is anterior to to the mucocutaneous junction ?
- thinly keratinised skin - we also see the openings of the meibomian gland
what is the grey line located anterior to the meibomian openings ?
- grey line located anterior to the meibomian openings marks the location of Riolans ( part of orbicularis oculi ) muscle and is an important surgical mark- its where they need to split the eyelid down the middle - that makes an incision bloodless as it it tend to avoid the major blood vessels within the eyelids
what is the function of eyelashes ?
- tend to be effective at trapping dust and debris and they tend to be coated with oily substance that tends to make them quite sticky helping them collect dust and debris and preventing it from entering the eye
- equipped with sensory receptors that initiate blink reflex
what is the lid wiper region at the eyelid ?
represent the point at which the eyelid margin contact the globe - it extends about 0.6mm from the mucocutaneous junction to the subtarsal fold
what is the function of lid wiper ?
region at the eyelid margin responsible for spreading tears during blinking
why do alteration of the lid wiper happen for contact lens wearers ?
alterations of the lid wiper region due to increased friction between this region and ocular or contact lens surface this is called lid wiper epitheliopathy which is disruption of surface epithelium
how can we see lid wiper ?
- stains with dyes such as fluorescein or lissamine green
- length and width of staining correlates with symptoms of dry eye ( particularly in subjects wearing contact lenses )
what are the positions and movements of eyelid controlled by ?
- controlled by a series of extra ocular muscles
what are the extra ocular muscles of the eyelids ?
- orbicularis oculi
- levator palpebrae superioris
- inferior and superior tarsal muscles ( or muller )