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Eyelid disease Flashcards

1
Q

What is avg length of palpebral fissure in med to large breed dogs?

A

33 mm

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2
Q

What muscle closes the lids?

A

Orbicularis oculi

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3
Q

What direction is lid closure? Why?

A

Lateral to medial; pushes tears to lacrimal puncta

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4
Q

What muscles open the upper lid? (list 3)

A
  1. Levator palpebrae
  2. Müller’s muscle
  3. Other superficial facial muscles
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5
Q

What muscle opens the lower lid?

A

Malaris muscle

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6
Q

What is another name for Müller’s muscle

A

levator anguli oculi medialis

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7
Q

How does the location of the eyelashes in dogs differ from people?

A

People, it is on the edge of the free margin. Dogs, it’s actually on the outer part of the lid, about 1 mm from the free margin in the upper lid and 2mm from the free margin on the lower lid

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8
Q

How many rows of cilia are there usually in dogs?

A

2-4

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9
Q

Where do meibomian glands open up?

A

In the edge of the free margin, in a fine groove

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10
Q

What is the groove that the meibomian glands open up into?

A

The “gray line”

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11
Q

Why is the “gray line” important?

A

Used as a surgical landmark to reappose lid margins

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12
Q

If you aren’t sure where the “gray line” is, what can you do?

A

Squeeze with forceps to get sebaceous material

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13
Q

Where can you see the meibomian glands, and what do they look like?

A

On the conjunctival surface of the lid

3-4 mm long, white-yellow lines perpendicular to the margin

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14
Q

Where are the glands of Zeis and Moll?

A

Just outside (in the direction of the lashes) of the gray line

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15
Q

What are the glands of Zeis and Moll?

A

Modified sweat glands (make lipid)

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16
Q

What is the purpose of the lipid layer made by the glands of Zeis and Moll?

A
  1. Prevent tears from flowing onto the lid

2. Helps prevent evaporation of the tears

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17
Q

How does the tarsal plate differ in the dog from a human?

A

It is thinner, and more flexible and fibrous

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18
Q

What does the tarsal plate do?

A

Provide site of attachment for muscles

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19
Q

Where is the lacrimal caruncle?

A

Medial canthus

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20
Q

What is different in the last 2-3 mm of the lids at the lateral canthus? (2 things)

A

No tarsal plate

No meibomian glands

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21
Q

Sensation to the lids:
Lateral 2/3 of upper lid?
Medial 1/3 of upper lid?
Lower lid?

A

Lateral 2/3 of upper lid: multiple branches of trigeminal
Medial 1/3 of upper lid: just the ophthalmic br of trigeminal
Lower lid: Maxillary br of trigeminal

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22
Q

What is the primary nerve that provides motor function to the lids? (be specific– name the branch)

A

Palpebral br of the facial nerve

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23
Q

What are the TWO muscles the facial nerve doesn’t innervate in the eyelids? What does innervate that muscle?

A
  1. levator palpebral superioris muscle

2. levator anguli oculi medialis

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24
Q

What innervates the levator palpebral superioris muscle

A

oculomotor (III) cranial nerve

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25
Q

What innervates the levator anguli oculi medialis?

A

Sympathetic nerve fibers

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26
Q

What happens if the levator anguli oculi medalis loses innervation?

A

ptosis of the medial upper lid

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27
Q

Where does lymphatic drainage of the lids converge?

A

Medial and lateral canthi

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28
Q

What TWO lymph nodes drains the lids? Why is this important?

A

Parotid ln and mandibular ln

Examine BOTH if there is neoplasia on the lid

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29
Q

Why does physiologic ankyloblepharon exist? (what happens if they open prematurely?)

A

Immaturity of ocular and adnexal tissues

If opens early, see exposure keratoconjunctivitis, severe ulceration, uveitis, possible perforation

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30
Q

When does the tissue between the lids of a puppy or kitten regress?

A

10-14 days

31
Q

If the palpebral fissure opens super early (like a couple days after birth), what probably needs to be done?

A

Temporary tarsorrhaphy with adjustable sutures

32
Q

If the palpebral fissure opens early, but not super early, what should be done?

A

Topical lubricants

33
Q

What bacteria usually affects the eyes in ophthalmia neonatorum?

A

Staphylococcus

34
Q

What is a possible cause for ophthalmia neonatorum?

A

Genital infection, which contaminates the puppy via the fissure at the medial canthus

35
Q

What happens if ophthalmia neonatorum is not quickly treated?

A

There can be irreversible damage to the lacrimal gland, cornea, or entire globe

36
Q

How do you open the eyelids if there is ophthalmia neonatorum?

A

Try gently massaging first;
if that doesn’t work, try spreading with mosquitos starting at opening at medial canthus;
if that doesn’t work may need to use scalpel to carefully incise at the medial canthus, then use Steven’s scissors to open the remainder at the line of separation

37
Q

Eyelid aplasia in DOGS– location most common?

A

Lateral and LOWER lid

38
Q

How do dogs with eyelid aplasia usually appear at birth?

A

Have lid partially or completely open even when neonates

39
Q

What is one mild form of eyelid aplasia?

A

Normal lid margin but no meibomian glands

40
Q

Where are dermoids most likely to be found?

A

Lower lid, near lateral canthus (disrupts the eyelid margin and is continuous with conjunctiva)

41
Q

Why are dermoids bad

A

Hair usually grows toward cornea, and blinking is abnormal

42
Q

What 3 dog breeds are genetically predisposed to dermoid?

A

GSD
St. Bernard
Dalmatian

43
Q

Why do distichia develop from meibomian glands? (vs say, all those other glands)

A

Meibomian glands are modified hair follicles, and distichia develop from undifferentiated gland tissue

44
Q

What is the issue with distichia? (2)

A
  1. Injury/pain to cornea (if stiff)… obviously

2. Can have a wicking action = overflow of tears over the lower lid margin (moistens margin and exterior aspect of lid)

45
Q

What breeds are most commonly affected by distichiasis?

A
  1. American (69%!) and English (49%) Cocker Spaniel
  2. Welsh Springer (48%) Spaniel
  3. Cavalier King Charles (24%)
  4. Flat Coated Retriever (31%)
  5. Boxer, English Bulldog, Shetland Sheepdog (25%)
  6. Shih Tzu, Pek, Tibetan Terrier, Doxie, Poodle, Jack Russel
46
Q

Is there a relationship with distichiasis and ectopic cilia?

A

Yes– more prone to having topic cilia

47
Q

Where else can you get distichia?

A

The openings for the glands of Zeis or Moll (… so any of these glands)

48
Q

If you are having trouble seeing/determining if the hairs are distichia, what is one additional feature you can look for?

A

Mucin adhering to hairs (although sometimes mucin can hide them)

49
Q

What are the 2 DDx for signs seen with distichia? (superficial keratitis, blepharospasm, mild conjunctivitis, excessive lacrimation)

A

Trichiasis and entropion

50
Q

How often is manual epilation needed for distichia?

A

q4-5 wks

51
Q

What is the benefits of manual epilation of distichia?

A
  1. Owners can do it
  2. Can confirm clinical signs are d/t distichia and not something else
  3. No anesthesia
52
Q

What dogs/breeds are at increased risk of ectopic cilia?

A

All the same breeds with distichia, and any other dog that you examine that has distichia

53
Q

What should you look for when examining for an ectopic cilia?

A

Pigmented conjunctiva around the hair

54
Q

Where (lid, and specific location) do you usually find ectopic cilia?

A

Upper lid, 4mm behind lid margin

55
Q

What breed is more likely to get bundles of ectopic cilia?

A

Shh Tzu

56
Q

What breed is more likely to get knots of ectopic cilia?

A

Poodle (surprise!)

57
Q

What does the associated corneal ulcer look like when a dog has an ectopic cilia?

A

Round, superficial defect, without undermined edges, and with vessels

58
Q

Breeding animal with ectopic cilia. OK to breed?

A

No, especially if in a breed that is normally NOT affected

59
Q

When is entropion considered mild, moderate, and severe?

A

Mild: tilted up to 45 deg
Mod: tilted up to 90 deg
Severe: tilted up to 180 deg

60
Q

3 causes of secondary entropion?

A
  1. Spastic
  2. Cicatricial
  3. Loss of lid support (phthisis bulbi, microphtalmos, muscle atrophy, retrobulbar fat resorption)
61
Q

What 4 breeds most commonly have entire lower lid entropion?

A
  1. Rottie
  2. Chow
  3. Shar Pei
  4. Bouvier des Flandres
62
Q

Those breeds with entire lower lid entropion usually have what wrong with the issue?

A

Fissure is relatively short

63
Q

Hunting breeds with entropion usually have what part involved?

A

Lower lid, lateral 3/4

64
Q

Giant breeds with entropion usually have what part involved?

A

Lower lid, lateral half; and lateral canthus

65
Q

What large/giant breeds are associated with entropion? (3)

A

GD, St. Bernard, Leonburger

66
Q

Large/giant breeds with entropion usually have what wrong with their lids that leads to entropion?

A

Large palpebral fissure

67
Q

What breeds have upper lid entropion?

A

Chow and Shar Pei (upper and lower for them!), Basset and Blood hound, Old English Cocker

68
Q

Why do those specific breeds have upper lid entropion?

A

Loose circum orbital skin, loose facial folds, heavy ears

69
Q

What breeds are associated with medial entropion?

A

Pug, Pek, Poodle (mini and toy), Shih Tzu, CKCS, Bulldog

70
Q

What breeds tend to have earlier onset to their entropion, and when (age) does it occur?

A

2-6 wks in Shar Pei and Chow

71
Q

In the majority of breeds, when (age) do you first see entropion?

A

4-7 months

72
Q

How does entropion result in a vicious cycle?

A

Pain–>enophthalmos–>loss of support of lid margin–>worsening entropion

73
Q

If you are unsure if there is entropion, what test can you do?

A

Pinch skin of lid ~10mm from margin, so lid inverts to cornea– should correct in 1 blink, if not then it is habitual entropion

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