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SEM 5: SAM 1 > Eyelids & 3rd eyelid > Flashcards

Eyelids & 3rd eyelid Flashcards

1
Q

What is the tarsus of the eye?

A

fibrocartilaginous layer of the eyelid that contains meibomian glands

(the holding layer for surgical eyelid closures)

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2
Q

What is the holding layer for surgical eyelid closures?

A

Tarsus of the eyelid ( fibrocartilaginous layer)

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3
Q

What is lagophthalmos?

A

Incomplete eyelid closure / coverage of the eyeball

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4
Q

What are the 4 layers of the eyelid from outside to inside?

A
  • Skin
  • Muscle (orbicularis oculi)
  • Tarsus
  • Conjunctiva
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5
Q

What muscles and nerves can be affected to cause lagophthalmos?

A

Muscle: Orbicularis oculi
Nerve: palpebral branch CN VII
Action: closes eyelids

Dysfunction causes lagophthalmos - incomplete closure of the eyelid

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6
Q

What muscles and nerves can be affected to cause ptosis?

A
  • levator palpebrae superioris m., innervated by CN III, opens upper eyelid
  • Muller’s muscle, sympathetic innervation, opens upper eyelid
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7
Q

____________ is rolling in of the eyelid margin such that hairs are touching the ocular surface

A

Entropion

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8
Q

What are the causes of hereditary entropion?

A
  • Abnormal medial canthus (common in brachycephalics)
  • Abnormal palpebral fissure (hounds, giant breeds)
  • Excessive facial folds (sharpeis)
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9
Q

What are the causes of acquired entropion?

A
  • Enophthalmos (dehydration, emaciation, muscle atrophy)
  • Chronic ocular pain causing blepharospasm associated entropion
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10
Q

How can you differentiate anatomic from blepharospasm entropion?

A

Use a topical anesthetic like proparacaine, if entropion resolves it was due to ocular pain causing blepharospasm

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11
Q

What treatment options are available for temporary correction of entropion?

A
  • Lubrication
  • Eyelid tacking (rolls out the eyelid)
  • Partial temporary tarsorrhaphy (brings eyelid margins together)
  • Hyaluronic acid subdermal filler (for old patients who can’t tolerate anesthesia)
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12
Q

What treatment options are available for permanent correction of entropion?

A
  • Hotz-Celsus (rolls out the eyelid)
  • Hotz-Celsus with lateral canthoplasty (rolls eyelid out and shortens palpebral fissure
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13
Q

What are the most common canine eyelid tumors?

A
  • Meibomian gland adenoma (most common)
  • Melanocytoma

usually benign tumors unlike cats

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14
Q

What are the most common feline eyelid tumors?

A
  • SCC (most common)
  • Fibrosarcoma
  • MCT
  • Adenocarcinoma

(mostly malignant tumors unlike dogs)

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15
Q

What are the treatment options are available for canine eyelid tumors?

A
  • Debulk and cryotherapy (great for tumors > 1/3 eyelid margin)
  • Complete excision
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16
Q

What suture pattern is used to close eyelid margin defects?

A

Figure 8 suture pattern

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17
Q

What are the causes of hereditary ectropion?

A
  • Abnormal palpebral fissure

(common in hounds and giant breeds)

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18
Q

What treatment options are available for permanent correction of ectropion?

A
  • Lateral canthoplasty (eyelid wedge resection), shortens palpebral fissure
  • V to Y plasty (rolls eyelid inward)
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19
Q

What are the common causes of lagophthalmos?

A
  1. Breed variation (brachycephalics)
  2. Exophthalmos
  3. Buphthalmos
  4. CN VII or CN V dysfunction
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20
Q

Dysfunction of what cranial nerves can result in lagophthalmos?

A

CN VII or CN V dysfunction

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21
Q

What is the treatment protocol for patients presenting with lagophthalmos?

A
  • ID underlying cause (breed vs CN dysfunction vs buphthalmos vs exopthalmos)
  • Temporary correction vs lubrication and temporary tarsorrhaphy
  • Permanent correction via permanent tarsorrhaphy or canthoplasty
22
Q

How can abnormalities of eyelid innervation be detected?

A
  • Abnormal palpebral reflex (CN V, CN VII)
  • Ptosis (drooping of upper eyelid)
  • +/- lip drooping
23
Q

What medication can be applied topically to diagnose Horners syndrome?

A

Phenylephrine

If affected pupil dilates in 20 mins = post ganglionic

If affected pupil dilates in 30-40 mins = pre ganglionic `

24
Q

What treatment options are available for permanent correction of eyelid agenesis?

A
  • Cryoepilation
  • Collagen injection
  • Reconstruction blepharoplasty (skin grafts, lip to lid transposition, oral mucosal graft)
25
Q

What is trichiasis?

A

Hairs growing from a normal location that are touching the conjunctiva/corneal surface

Ex: Excessive facial folds causing hair of folds to touch the eye

26
Q

What options are available for conservative and aggressive treatment of trichiasis?

A

Conservative - frequent lubrication
Aggressive - Facial fold resection, medial canthoplasty

27
Q

What is distichia?

A

Cilia that emerges from the meibomian glands

(meibomian gland is part of the tarsus, which is underneath where normal eyelashes should be)

28
Q

What options are available for treatment of distichia?

A

1. Cryotherapy / Cryoepilation
(freeze the abnormal eyelash, apply probe to palpebral conjunctiva)
**Caution: eyelid necrosis and depigmentation

2. Thermal cautery (burns the abnormal eyelash)
** Caution: charred material in eye causing further irritation

only requires tx if causing corneal or conjunctival dz

29
Q

What is ectopic cilia?

A

Eyelashes protruding through palpebral conjunctiva (inner mucosa of eyelids, touching the eyeball)

30
Q

How do patients with ectopic cilia present?

A
  • Severe pain and corneal disease
  • CS wax and wane due to hair life cycle
  • Ulceration
  • Keratitis (inflammation of the cornea)
31
Q

What options are available for treatment of ectopic cilia?

A

Surgical excision with cryotherapy

(isolate hair follicle and evert eyelid, excise hair follicle and freeze)

32
Q

_________ is inflammation of the eyelid

A

Blepharitis

33
Q

List inflammatory eyelid disorders

A
  1. Chalazion
  2. Hordeolum (Stye)
  3. Blepharitis (bacterial, fungal, parasitic, immune mediated)
34
Q

What is chalazion?

A

Enlargement of the meibomian gland due to blockage of its duct

35
Q

How is chalazion treated?

A
  1. Warm compress
  2. Surgical incision and drainage
  3. Topical Abx with steroids
36
Q

What is Hordeolum?

A

Purulent bacterial infection of the meibomian gland

(Staph aureus most common)

37
Q

What clinical signs can be seen in patients with hordeolum?

A
  • erythema and swelling of the lids
  • pruritis
  • painful
  • chemosis
  • conjunctivitis

(Hordeolum - purulent bacT infection of the meibomian gland)

38
Q

What is the treatment protocol for bacterial blepharitis?

A
  1. Systemic Abx for 3-4 weeks
  2. Topical Abx + steroid ointment
  3. Warm compress

(Amoxiclav, doxycycline, cephalosporin)

39
Q

What is a parasitic cause of blepharitis?

A

Demodex

40
Q

What are immune mediated causes of blepharitis?

A
  • Pemphigus diseases
  • Medial canthal ulcerative blepharitis
41
Q

What can occur if cherry eye is left untreated?

A
  • Chronic conjunctivitis
  • KCS (dry eye)

**3rd eyelid contributes to 35-45% of the the aqueous tear film

42
Q

When is complete excision of the 3rd eyelid an appropriate treatment option?

A

Only indicated if neoplasia

never indicated for cherry eye

43
Q

What treatment options are available for patients with prolapse of the 3rd eyelid?

A

1. Morgan pocket technique
2. Orbital tacking

44
Q

A ________ shaped incision should be made in cases of eyelid tumor removal

A

House

45
Q

Which of the following is a surgical treatment option for trichiasis?

A. Lateral canthoplasty
B. Medial canthoplasty
C. Cryotherapy
D. Orbital tacking

A

B. Medial canthoplasty

46
Q

Which of the following is a surgical treatment option for prolapse of the 3rd eyelid?

A. Lateral canthoplasty
B. Medial canthoplasty
C. Cryotherapy
D. Orbital tacking

A

D. Orbital tacking

(also Morgan pocket technique)

47
Q

Which of the following is a surgical treatment option for ectropion?

A. Lateral canthoplasty
B. Medial canthoplasty
C. Cryotherapy
D. Orbital tacking

A

A. Lateral canthoplasty

(also can do V to Y plasty)

48
Q

Which eyelid condition can be treated surgically using a V to Y plasty?

A

Ectropion

49
Q

Which of the following is a surgical treatment option for entropion?

A. Hotz Celsus
B. Medial canthoplasty
C. Cryotherapy
D. Orbital tacking

A

A. Hotz Celsus (+ lateral canthoplasty)

(taking out a piece of skin underneath the eye and then suturing it back together)

50
Q

A lip-to-lid transposition can be a surgical treatment option for which of the following eyelid disorders?

A

Eyelid agenesis

51
Q

Which eyelid disorder should be reconsidered at 8-12 months, once a dog grows into their face?

A

Entropion

SEM 5: SAM 1 (35 decks)

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