EYELIDS Flashcards
Glands of eyelids
1. Meibomian glands…30 to 40 in upper tarsal plate and 20 to 30 in lower tarsal plate
2.Gland of zeis
3.Glands of Moll
4.What is a chalazion?
5.complications ?
6.treatment?
- Produce oily secretion for tear film.
2.Sebaceous glands.
3.sweat glands.
4.chronic sterile inflammatory lipo granuloma of the meibomian gland.
Due to obstruction in orifice of meibomian glands there is lipid accumulation then Inflammatory cells surround the lesion producing swelling in the lid . More common in upper eyelids.
If eyelid is everted , conjunctival congestion over the chalazion may be noted.
5.Mechanical ptosis
Astigmatism due to pressure over the eye
Calcification will produce a hard nodule.
- Usually self resolving
.conservative TTT…warm compresses,topical steroid-antibiotic combination drops.
Medical TTT …triamnicilone inj.
Systemic antibiotics
Surgical TTT…vertical incision of the lesion.
Topical steroid antibiotics post op.
1.what is Hordeolum? And its types?
2.most common organism responsible?
3.Treatment?
1.Infectious nodule that develops in the eyelids.
Hordeolum externum(stye)…. Acute suppurative infection of glands of zeis or Moll.
Hordeolum internum…Acute suppurative infection of meibomian glands.
2.staphlococcus aureus.
3.presents with pain and tenderness in eye.
Analgesics for pain.
Systemic or topical antibiotics.
Warm compresses.
Evacuation of pus by incision.
1.What is blepharitis?
2.Types
3.What is Infective blepharitis?
4.What is squamous blepharitis?
5.What is meibomianitis?
6.Treatment of blepharitis?
- Inflammation of eyelid margins.
Anterior blepharitis
Can be
🎟️…infective/ulcerative/ staphylococcal blepharitis
🎟️…Non infective/Squamous/seborrheic blepharitis
Posterior blepharitis/meibomianitis
3.infection of lash follicle and associated gland of zeis and Moll.
Caused by staphylococcus aureus.
Itching, lacrimation,gluing, photophobia,yellow pus forming crusts may occur .
- Disorder of gland of zeis or Moll.
Ass. with seborrheic dermatitis,acne rosacea and atopic dermatitis.
Gland of zeis secrete neutral lipids which are split by corynebacterium into irritating free fatty acids.
Shiny waxy or greasy eyelashes,dandruff like material on eyelashes.
5.inflammation of meibomian glands causing hypersecretion of the glands.
Orifice of meibomian glands may be capped by small oil globules. White frothy secretion on eyelid margins.oily secretion comes out when glands are massaged.
6.Eyelid hygiene.
Topical steroids
Topical antibiotics in anterior blepharitis and systemic in posterior blepharitis.
Selenium sulphide shampoo in case of ass with seborrheic dermatitis.
Artificial tears when tear film instability is there.
1.Trichiasis?
2.treatment?
3.pseudotrichiasis?
4.Distichiasis?
1.misdirection of eyelashes towards the globe.
2.epilation,electrolysis, cryotherapy,argon laser,full thickness wedge resection when trichiasis is confined to one segment of the eyelid.
3.misdirection of eyelashes secondary to entropion.
4.abnormal ,additional row of eyelashes often directed backwards.
- What is entropion?
2.types?
3.treatment of each cause?
- A condition where eyelid margins are turned towards the eyeball.
2…..Congenital…dev. deformity of tarsal plate.
…….Acquired
🎟️Senile/involutional…. overriding of preseptal over the pretarsal part of orbicularis Oculi due to atrophy of lower lid retractors.
🎟️Cicatricial…due to scarring of palpebral conjunctiva due to SJS,trachoma,chemical burns.
🎟️Spastic… excessive contraction of orbicularis Oculi
3.congenital…resection of abnormal portion and placing the remainder in normal position.
Spastic …eyelid everting sutures,tape and botulinum toxin.
Cicatricial…tarsal hinge procedure
Senile… horizontal resection of orbicularis oculi muscle in weiss procedure,fox procedure.
1.What is ectropion?
2.types?
3.what are features of ectropion?
4.what are grades of ectropion?
5.treatment?
1.a condition where eyelid margins are everted away from the eyeball.
2.congenital
Acquired
Senile
Cicatricial
Paralytic…facial nerve palsy
3.Epiphora
Conjunctivitis and exposure keratitis due to exposure.
4.grade 1…punctum is everted only.
Grade 2..lid margin is everted and palpebral conjunctiva is visible
Grade 3…forniceal conjunctiva is also visible.
5.senile…conjunctivoplasty,horizontal lid shortening
Cicatricial…excision of scar tissue and repair of defect by VY procedure or skin grafts.
Paralytic… tarsorrhaphy
Congenital…surgical repair
1.What is ptosis/Blepharoptosis?
2.classify ptosis!
3.differentiate bw ptosis of 3rd nerve palsy and horner syndrome!
- Degrees of ptosis?
1.abnormal drooping of upper eyelid.
2.congenital…include
🎟️simple congenital ptosis
🎟️Marcus Gunn jaw winking ptosis/synkinetic ptosis…cross innervation of oculomotor nerve and trigeminal nerve supplying muscles of mastication causes retraction of eyelids with mastication.
🎟️Blepharophimosis …..ptosis,telecanthus,epicanthus inversus
Acquired includes
🎟️Neurogenic…in 3rd nerve palsy or horner syndrome.
🎟️Myogenic …due to myasthenia gravis(ice test and tension test) ,ocular thyropathy or Myotonic dystrophy
🎟️Aponeurotic due to dis insertion or stretching of levator aponeurosis
🎟️Mechanical…due to eyelid tumor or chalazion
3.complete ptosis,ocular movement restriction and pupillary dilation occurs in 3rd nerve palsy.
Ipsilateral miosis,lower lid elevation and anhidrosis occurs in horner syndrome.
4.mild…1 to 2mm covers upper part of pupil.
Moderate…3mm covers upper half of pupil
Severe…4mm covers whole pupillary area.
