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Ophthalmology > Eyelids > Flashcards

Eyelids Flashcards

1
Q

List the glands of the eyelids

A
  1. Meibomian/tarsal glands
  2. Glands of Zeis
  3. Glands of Moll
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2
Q

Summarise the glands of the eyelids

A
  • Their secretions form a part of the PTF (precorneal tear film)
  • This coats the lid margins, preventing the tear overflow
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3
Q

List the muscles of the eyelid

A
  1. m. orbicularis oculi
  2. m. levator palpebrae
  3. m. malaris

These all connect with the tarsus (CT of the eyelid)

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4
Q

Give the functions of the eyelid

A
  1. Physical protection of the globe
  2. Distribution of the PTF; pumping it into the drainage system
  3. Production of phospholipid-rich secretion
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5
Q

List the notable lesions seen in the eyelid

A
  1. Prominent nasal fold
  2. Disorders of the ciliae
  3. Entropion
  4. Ectropion
  5. Hordeolum
  6. Blepharitis
  7. Trauma
  8. Neoplasia
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6
Q

Notable lesion seen in the eyelid: Prominent nasal fold

  • CSx
  • Tx
A
  • Brachycephalic breeds; permanent irritation to the cornea
  • CSx: Lacrimation; medial pigmentation & corneal vascularisation
  • Tx: Sx removal of the fold; tx of 2° corneal ulcers
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7
Q

Notable lesion seen in the eyelid: List the disorders of the ciliae

A
  1. Districhiasis
  2. Trichiasis
  3. Ectopia ciliae
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8
Q

Disorder of the ciliae: Distichiasis

A

Additional ciliae originating from abnormally located follicles

Follicles are in/near the tarsal gland

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9
Q

Disorder of the ciliae: Trichiasis

A

Ciliae arising from the normally located follicles point in abnormal directions

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10
Q

Disorder of the ciliae: Ectopia ciliae

A

Additional cilia originating from the abnormally located follicle

The follicle may be located anywhere e.g under the palpebral conjunctiva

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11
Q

Disorders of the ciliae: Signs to look for

A
  • Abnormal ciliae rub the corneal surface & conjunctiva
  • Conjunctival hyperaemia
  • Lacrimation
  • Blepharospasm
  • Miosis
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12
Q

Disorders of the ciliae: Treatment

A
  • Trimming of the aberrant ciliae (by owner)
  • Electroepilation & microepilation
  • Surgical excision
  • Treatment of any 2° corneal erosions
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13
Q

Notable lesion seen in the eyelid: Entropion

A

Inward turning of the eyelid margin

  • Developmental or structural
  • Acquired or congenital
  • Spastic

Usually caused by the lower lid

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14
Q

Developmental/structural entropion: Incidence

A
  • Lambs (upper lid)
  • Dogs (lower lid)
    • Usually affecting both eyes & whole lid margin
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15
Q

Developmental/structural entropion: Predisposed dog breeds

A
  • Rottweiler
  • Chow chow
  • St. Bernard
  • Great Dane
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16
Q

Acquired/cicatrical (scar) entropion: Aetiology

A
  • Trauma to the lids → scar formation & skin contraction
  • May be caused by periocular surgery or chronic inflammation
  • Frequent in horses

This is the same aetiology as ectropion

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17
Q

Spastic entropion: Aetiology

A

Ocular pain/discomfort → Blepharospasm → 2° Entropion

  • Common in dog
  • Topical anaesthesia: Helps to make a dx whether the condition is structural or spastic
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18
Q

Entropion: Signs to look for

A
  • Lacrimation, blepharospasm or photophobia
  • Conjunctivitis
  • Rubbing of the eye
  • Corneal oedema, vascularisation, pigmentation
  • Ulceration
  • Turning of the lid margin
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19
Q

Entropion: Treatment

A

Surgery

Developmental entropion: May improve spontaneously in immature dogs

20
Q

Entropion treament: Surgical techniques

A

Prior to anaesthesia, the lid is inverted to estimate how much skin is to be removed

  • Hotz-Celsus technique
  • “Pinch” technique
21
Q

Entropion surgery: Postoperative tx

A
  • ABx; NSAIDS; Elizabethan collar
  • Sutures removal after 10-12 days
  • Spastic entropion: Tx of the underlying condition
22
Q

Notable lesion seen in the eyelid: Ectropion

A

Eversion & turning out of the eyelid; Always the lower eyelid

  • Developmental or structural
  • Acquired or cicatrical
  • Intermittent
23
Q

Developmental/structural ectropion: Aetiology

A

Mainly in dogs

  • Possible genetic basis
  • Some ectropion is considered normal in some breeds of dog
  • CSx may be absent
24
Q

Acquired/cicatrical ectropion: Aetiology

A
  • Trauma to the lids → scar formation & skin contraction
  • May be caused by periocular surgery or chronic inflammation
  • Frequent in horses

This is the same aetiology as entropion

25
Intermittent ectropion: **Summary**
* Seen in larger hunting breed of dogs (setters & retrievers) * Eyelids are normal in the morning; Ectropion seen **at night** * Unknown mechanism * **Surgery is contraindicated**
26
Ectropion: **Signs to look for**
* Lacrimation & conjunctivitis * Corneal vascularisation in advanced cases * Eversion of the lower lid
27
Ectropion: **Treatment**
Many animals tolerate slight ectropion Indications for surgery: * Presence of secondary signs * If it is desired by the owner
28
Ectropion: **Surgical technique**
**Modified Kuhnt-Szymanowski** method
29
Ectropion surgery: **Postoperative tx**
* ABx; NSAIDS; Elizabethan collar * Suture removal after 10-12 days
30
Notable lesion seen in the eyelid: **Hordeolum**
Hordeolum **externum** or Hordeolum **internum** * **Externum**: Purulent inflam. of a **lash follicle** & **gland of Zeis** * **Internum**: Purulent inflam. of a **tarsal gland** Caused by **S. aureus**
31
Hordeolum: **Signs to look for**
* Focal & painful microabscesses on the lid margin * Yellowish; up to 10mm in diameter
32
Hordeolum: **Treatment**
Medical management / Surgery
33
Notable lesion seen in the eyelid: **Blepharitis**
Inflammation of the eyelid **Classified by:** * **Aetiology:** Bacterial; mycotic; parasitic; allergic * **Location:** Unilateral; bilateral; upper; lower; both * **Expansion:** Focal; diffuse
34
Blepharitis: **Signs to look for (Acute)**
* Pain; blepharospasm; pruritis; alopecia * Swelling; hyperaemia; sero-purulent discharge
35
Blepharitis: **Signs to look for (Chronic)**
* Ulceration & fibrosis * May have associated conjunctivitis/keratoconjunctivitis
36
Blepharitis: **Laboratory testing available**
* **Cotton swab sample:** Bacteriology * **Scraping:** Parasites * **Skin biopsy:** Fungi
37
Blepharitis: **Treatment**
Dependent on the cause; Elizabethan collar needed * Bacterial * Fungal * Parasitic * Allergic
38
Causes of blepharitis: **Bacterial infection**
*Staphylococcus* & *Streptococcus spp.* * **Acute Tx:** Hot compress & washing; topical & systemic **ABx** * **Chronic Tx:** Topical & systemic **ABx** & **steroids**
39
Causes of blepharitis: **Fungal infection**
* Microsporum* & *Trichophyton spp.* * Tx: Topical & systemic fungicides * Avoid contact between the drug and the cornea*
40
Causes of blepharitis: **Parasitic infection**
* Demodex* & *Sarcoptes spp.* * Tx: Topical & systemic parasiticides * Avoid contact between the drug and the cornea*
41
Causes of blepharitis: **Allergies**
Tx: * Elimination of the allergen * Topical & systemic steroids
42
Traumatic injuries to the eyelid: **Signs to look for**
* May be just in the skin or full thickness of the lid * Varying size of laceration * Fresh injuries: Intensive bleeding It's important to evaluate the **globe** & **lacrimal punctas**' condition
43
Traumatic injury to the eyelid: **Treatment**
**Wound management** * Repair to restore anatomic & functional integrity ASAP after injury * Untreated injury → **Cicatricial entropion/ectropion**
44
Notable lesion seen in the eyelid: **Tumour**
* Equally common amongst all species * Malignant or benign; metastasis is **rare**
45
Tumour of the eyelid: **Signs to look for**
* Malignant tumours: Locally invasive → Loss of function & deformity * Pain; discharge; ulcer; haemorrhage; lacrimation; dry eye surface
46
Tumour of the eyelid: **Treatment**
**Surgery** ​*Radiotherapy; chemotherapy*

Ophthalmology (9 decks)

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