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A seg > Eyelid Malpositions > Flashcards

Eyelid Malpositions Flashcards

1
Q

Dermatochalasis

  • What is it
  • Cause
A

Lax and redundant upper eyelid skin

Degeneration of connective tissue most commonly the result of aging.

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2
Q

Dermatochalasis
Demographics
Laterality

A

Elderly

Bilateral

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3
Q

Dermatochalasis
Symptoms
Signs

A

Asymptomatic, droopy eyelid, obstruction of superior visual field.

Upper eyelid skin laxity and redundancy
Decreased MRD 1 (Marginal reflex distance. Between K reflex and UL margin. 4-4.5 is normal)

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4
Q

Dermatochalasis

Management

A

None if asymptomatic.

If symptoms, refer out for blepharoplasty. Prior, perform a VF with lids taped vs untaped.

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5
Q

Ptosis

  • What is it
  • Cause
A

Droopy upper eyelid

Most commonly aponeurotic (levator stretching or dehiscence due to aging/repetitive eye rubbing)

Less commonly
Mechanical (eyelid tumor)
Myogenic (muscular dystrophy)
Neurologic (Horner, myasthenia gravis, MS)

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6
Q

Ptosis

  • Demographics
  • laterality
A

Depends on cause

Unilateral more common

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7
Q

Ptosis
Symptoms
Signs

A

No symptoms, droopy eyelid, obstruction of superior VF.

Signs- UL most commonly affected. Decreased MRD1 and maybe 2. Signs of underlying cause could be chalazion, EOM restriction, anisocoria, diplopia, high/absent eyelid create if aponeurotic.

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8
Q

Ptosis

Management

A

Determine and treat the underlying condition.

If no resolution, refer out for surgery

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9
Q

Pseudoptosis

A

Dermatochalasis, brow ptosis, enopthalmos, micropthalmia, corneal protective mechanisms, contralateral eyelid retraction.

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10
Q

Entropion

  • What is it
  • cause
A

Eyelid turns in towards globe
Most commonly age related
Less commonly: Cicatricial (Conj scarring in trauma, burn injury, trachoma), spastic, congenial

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11
Q

Entropion
Demographics
Laterality

A

Most commonly presents in the elderly

Unilateral or bilateral

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12
Q

Entropion
symptoms
Signs

A

Symptoms- Asymptomatic, ocular redness, ocular irritation, tearing.

sings- inversion of eyelid. May have underlying cause- conj scarring, spastic contraction of OO muscle.

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13
Q

Entropion

Complications

A

Trichiasis –> Ocular surface damage.

Conj injection, SPK, pannus, K ulcer

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14
Q

Entropion

Management

A

Determine and treat underlying condition. If no resolution, refer out for surgery.

Supportive management for trichiasis- lash epilation, aggressive topical lubrication, bandage CL.

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15
Q

Ectropion

  • What is it
  • Cause
A

Eyelid turns out away from globe
Most commonly age related due to horizontal eyelid laxity.

Less commonly due to mechanical (eyelid tumor), cicatricial, neurologic, congenital.

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16
Q

Ectropion
Demographics
Laterality

A

Most commonly presents in the elderly

Unilateral or bilateral

17
Q

Ectropion
Symptoms
Signs

A

Asymptomatic, ocular redness, ocular irritation, tearing.

Signs- Eversion of the eyelid. LL is most commonly affected. Might have underlying cause such as eyelid tumor, eyelid scarring, paralysis of facial muscles.

18
Q

Ectropion complications

A

Lagophthalmos causing exposure keratopathy.

19
Q

Ectropion management

A

Determine and treat the underlying condition. If no resolution, surgery.

Supportive management for exposure keratopathy.

20
Q

Eyelid Retraction

  • What is it
  • Cause
A

Excessive elevation of the eyelid.

Most commonly due to thyroid eye disease. Increased sympathetic tone acting on miller’s muscle, contraction of levator, proptosis and or scarring between the lacrimal gland and levator.

Less commonly mechanical, cicatricial, neurological, pharmacological, congenital.

21
Q

Eyelid Retraction
Demographics
Laterality

A

Women > men

Unilateral or bilateral

22
Q

Eyelid Retraction

  • Symptoms
  • Signs
A

Asymptomatic, ocular redness, irritation.

Excessive elevation of the eyelid. UL most commonly affected. Increased MRD1 and or 2. Signs of underlying cause such as proptosis, deficiency in upward gaze, UL retraction and pupillary constriction on downsize and adduction, dilated pupil.

23
Q

Eyelid Retraction complications

A

Lagophthalmos –> Exposure keratopathy. Supportive management

24
Q

Floppy eyelid Syndrome

  • What is it
  • Cause
A

Flaccid upper eyelids due to a lax tarsal plate

Cause is unknown. May be due to sleep apnea.

25
Q

Floppy eyelid Syndrome

Demographics and laterality

A

Typically presents between ages of 45-65.
Men > women

Bilateral

26
Q

Floppy eyelid Syndrome
Symptoms
Signs

A

Symptoms- Asymptomatic, ocular redness, irritation, mild mucous discharge, symptoms can be unilateral based on the side they sleep on.

Signs- Upper eyelids that are easily everted, rubbery tarsal plate, Eyelid imbrication (UL overrides the LL on closure), conj injection, palpebral papillae superior, SPK, mild mucous discharge, ptosis.

27
Q

Floppy eyelid Syndrome

Complications

A

Lagophthalmos due to eyelid imbrication –> exposure keratopathy.

Bacterial conjunctivitis due to eyelid eversion during sleep

28
Q

Floppy eyelid Syndrome Management

A

Supportive management
Topical lubricant, eyelid taping or patch qhs, don’t sleep face down.

Refer out for surgery for definitive treatment.

If not previously diagnosed, refer to PCP for sleep apnea.

29
Q

Lagophthalmos

  • What is it
  • Cause
A

Incomplete closure of the eyelids

Could be mechanical, cicatricial, neurologic, congenital.

30
Q

Lagophthalmos

  • Demographics
  • Laterality
A

Depends on cause

Unilateral or bilateral

31
Q

Lagophthalmos
Symptoms
Signs

A

Asymptomatic, ocular redness, irritation, tearing.

Signs- inadequate blinking or closure of the eyelids. Signs of underlying cause such as eyelid tumor, proptosis, chemises, eyelid scarring, restriction in upgrade.

32
Q

Lagophthalmos
Complications
Management

A

Complications- Exposure keratopathy.

Management- Determine and treat the underlying condition.
If no resolution, refer out for treatment. Supportive management for exposure keratopathy.

A seg (33 decks)

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