Eyelid, lacrimal + orbital diseases Flashcards
What does blinking do?
spreads a film of tears across the eyes
replenishes moisture
Drying of ocular surface symptoms
irritation
stinging
burning
red sticky eye in morning
What is lagophthalmos?
incomplete eye lid closure
Entropion causes
lid laxity/aging
congenital
spastic
cicatricial
Entropion symptoms
irritation
watering
grittiness
stickiness
recurrent infections
Entropion treatment
lubricants
taping
botox
surgery - everting sutures, lid tightening
Ectropion causes
laxity/aging
paralytic - CNVII palsy
cicatricial
Ectropion symptoms
often asymptomatic
watering
red appearance to the eyes
discharge
blurred vision
if exposure - stinging + pain
Ectropion treatment
lubrication
surgery
What can cause sudden onset ptosis?
Horner’s syndrome
Third nerve palsy (eyes down and out)
Ptosis causes
congenital:
- dystrophic muscle
acquired:
- aponeurotic/senile
- traumatic
- neurogenic
- myogenic
- mechanical
What would suggest an eyelid lesion is benign?
long history
gradual change
often asymptomatic
may be tender (acute syte)
What would suggest an eyelid lesion is malignant?
recent onset
rapid growth
bleeding
pigmented
Examination features of a benign eyelid lesion
distinct edges
cystic
no lash loss
no destruction of lid architecture
Examination features of a malignant eyelid lesion
ill-defined borders
loss of lashes
destruction of lid architecture
bleeding
ulceration
diplopia
extension into orbit
What is dacryocystitis?
inflammation of the lacrimal sac
What is dacryoadenitis?
inflammation of the lacrimal gland
Symptoms of orbital disease
diplopia
swelling around eye
bulging prominent eye
awareness of a lump
ache behind eye
pain on eye movements
Signs of orbital disease
restricted eye movements
swelling around eye
proptosis
lid retraction
reduced vision
reduced colour vision
pupil abnormalities
How is proptosis measured?
using an exophthalmometer
What is the most common cause of proptosis?
thyroid eye disease
Red flags for urgent referral to ophthalmology
exposure of the eye
double vision + ptosis
reduced vision
rapidly growing suspicious eye lid lesion
proptosis
swelling in lacrimal gland or sac area
entropion
Reasons for a routine ophthalmology referral
long-standing lid lesion with no suspicious features
gradual onset adult ptosis
non-painful ectropion
watery eye alone
