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RUSVM SAM 2 > Eyelids > Flashcards

Eyelids Flashcards

1
Q

What are the 4 layers of the eyelid?

A

Skin
Muscle
Tarsus
Conjunctiva

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2
Q

What is the main function of the skin of the eyelid?

A

Sensory protection

CN V maxillary and ophthalmic branches of ophthalmic

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3
Q

What muscle functions to open the eyelid?

A

Levator palpebrae superioris (oculomotor nerve)

Mullers muscle (sympathetic innervation)

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4
Q

What muscle functions to close the eyelids?

A

Orbicularis oculi

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5
Q

Dysfuntion of the levator palpebrae superioris causes drooping of the eyelid, which is called?

A

Ptosis

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6
Q

Dysfuntion of the orbicularis oculi causes incomplete closure of the eyelids, which I is called?

A

Lagophthalmos

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7
Q

What is the tarsus of the eyelid?

A

Fibrous and glandular layer

== holding layer for surgical closure

Supports meibobmian glands

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8
Q

What do you call rolling of the eyelid margin so that the hairs are touching the ocular surface?

A

Entropion

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9
Q

What are the two types of entropion?

A

Anatomic — hereditary or acquired

Blepharospasm — stimulated by ocular pain and globe retraction

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10
Q

What are hereditary entropion causes?

A

Abnormal medial canthus—brachycephalic

Abnormal palpebral fissure — often too large and loose in hounds and giant breeds

Excessive facial folds

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11
Q

What are acquired causes of anatomic entropion?

A

Enophthalamos

Blepharospasm (ocular pain causes blepharospasm —> entropion—> more irritation and pain)

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12
Q

How can we differentate anatomic and blepharospasm entropion ?

A

Take away the pain that causes the blepharospasm —- procaracaine

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13
Q

Why do we need to differentate between anatomic and blepharospastic components of entropion?

A

Failure to assess the spastic component can lead to over correction and ECTroption

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14
Q

You have determined that an entropion in your patient is secondary to dehydration retaliated enophthalamos.

How would you treat this?/

A

Temporary correction

Viscous lubrication
Eyelids tacking (rolls out the eyelid)
Partial temporary tarsorrhaphy brings eyelid margins together

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15
Q

Your patient has a congenital entropion due to excessive facial folds.. how will you treat this?

A

temporary suture tacking — until grown into face

If not fixed once growth is complete… permanent correction
— modified hotz-celsus (rolls out the eyelid)

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16
Q

What do you call an eversion or rolling out of the eyelid?

A

Entropion

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17
Q

Common causes of ectropion?

A

Iatrogenic — overcorrection of entropion

Hereditary in hounds and giant breeds

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18
Q

Treatment if ectropion ?

A

Lateral eyelids wedge excision

V to U plasty

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19
Q

What are common causes of lagophthalmos?

A

Breed variation
Exophthalmos
Buphthamos
CN V or CN VII dysfunction

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20
Q

Temporary treatment of lagophalmos?

A

Lubrication or temporary tarsorrhaphy

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21
Q

Permanent treatment of lagophthalmos ?

A

Permanent tarsorrhaphy

Canthoplasty

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22
Q

What is horners syndrome?

A

Loss of sympathetic innervation —> lack of tone of orbital smooth and skeletal muscle

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23
Q

What clinical signs are associated with horners syndrome?

A

Enophthalamos
Passive elevation of third eyelid

Ptosis

Miosis

24
Q

What is the EDx of horners syndrome

A

Idiopathic (most cases)

Injury/infarction/neoplasia of thoracic spinal cord
Avulsion of brachial plexus
Thoracic inlet or cranial mediastinal lesions
Injury or neoplasia of cervical sympathetic trunk
Otitis media
Nasopharyngeal polyps
Retrobulbar disease

25
How can you confirm and localize horners syndrome?
Phenylephrine (diluted to 1%) Normal eye— dilation should occur in 60 to 90minutes Affected eye —post ganglionic -> dilation in 20mins —pre ganglionic -> dilation in 30-40mins
26
What are three conditions of abnormal hairs that can cause irritation to the cornea or conjunctiva
Trichiasis Disctichiasis Ectopic cilia
27
Hairs growing from normal skin and reach the cornea/conjunctival surface are called?
Trichiasis
28
Treatment for trichiasis?
Conservative — lubrication Aggressive — facial fold resection, medial canthoplasty (must preserve nasolacrimal duct)
29
What do you call cilia that emerge from the meibomian glands?
Distichia
30
What breeds can have an inherited ditichia?
Cocker spaniel Poodles Sheepdogs
31
Treatment for distichia and ectopic cilia?
Cryotherapy - two freeze thaw cycles - then pluck Multiple treatments required
32
What do you call hair/cilia protruding through the palpebral conjuntiva?
Ectopic cilia Cause pain and corneal disease (ulcers)
33
Canine tumors mostly demonstrate (malignant/benign) characteristics
Benign
34
Feline eyelids tumors mostly demonstrate (malignant/benign) characteristics
Malignant
35
What are the most common canine eyelid tumors?
Meibomian gland adenoma Melanocytoma
36
Most common tumors of feline eyelid?
Squamous cell carcinoma Fibrosarcoma Mast cell tumor Adenocarcinoma
37
What are three common factors to consider before removing an eyelid tumor in a canine?
Irritation? - causing KCS? Size? — cannot remove more than 1/3rd of eyelid margin Location — involving nasolacrimal ducts or canthus??
38
What are the treatment options for eyelid tumors?
Debulk and cryotherapy -higher chance of regrowth Complete excision -must reconstruct eyelids margin
39
What are the four key concepts when closing eyelid margin defects?
Limited debridement Closure must be perfect Avoid full thickness suture bites Tarsus is the holding layer
40
What suture pattern do you use when bringing the eyelid margin back together?
Figure 8 First bite from skin to defect Defect to eyelid margin Eyelid margin to defect Defect back to skin
41
What do you call inflammation of the eyelids?
Blepharitis
42
What do you call an enlargement of the meibomian gland due to blockage of its duct and inspissation of its secretory products?
Chalazion
43
How do you treat a chalazion?
Warm compresses Surgical incision and drainage (chalazion curette) Tropical antibiotic with steroids
44
What do you call a purulent bacterial infection of the meibomian gland? What if multiple are involved?
Hordeolum Meibominanitis (multiple)
45
What are signs of hordeolum, and the most common bacteria involved?
``` Erythema and swelling of lids Pruritus Pain Chemosis Conjunctivitis ``` Staph aureus
46
Therapy for bacterial blepharitis?
``` Initially Systemic antibiotics -amoxicillin-clavulanic acid -doxycycline -cephalosporin ``` Tropical antibiotic-steroid ointment Warm compress
47
The third eyelid is located?
Ventral and medially
48
There are two surfaces of the third eyelid, both lined with conjunctiva. What are they?
Palpebral surface Bulbar surface
49
What provides the support for the third eyelid?
T shaped cartilage
50
What lives at the base of the T shaped cartilage of the third eyelid?
Gland of the third eyelid
51
What is cherry eye?
Prolapse of the third eyelid
52
What happens if you leave cherry eye untreated?
Contributes 35-45% of the aqueous tear film Chronic conjunctivitis KCS
53
T/F: excision of the glad in an appropriate treatment for cherry eye
False The ONLY indication for removal is neoplasia
54
Treatment for cherry eye?
Morgan pocket technique -incise over bulbar conjunctiva inferior and superior to gland and connect the incision Orbital tacking - third eyelid is elevated, cut made through orbital rim and conjuntiva - suture passed through incision to engage periosteum, then through the palpebral surface to engage gland - anchors eyelid in more ventral position
55
Possible complication to morgan pocket technique?
If tears are not allowed to drain at either end of incision, cyst may form

RUSVM SAM 2 (44 decks)

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