Lecture 6 2/6/25 Flashcards
What are the general characteristics of the eyelids?
-haired skin on outside
-conjunctiva lining on inside
-eyelid margin between the haired skin and conjunctiva where the meibomian gland openings reside
Which nerve and muscle work together to close the eyelids?
CN7 and orbicularis oculi m.
Which nerve and muscle work together to open the eyelids?
CN3 and levator palpebrae m.
What are the characteristics of ankyloblepharon?
-fusion of upper and lower eyelids
-normal for the first 10-15 days of life in some mammals
-premature opening can lead to dry corneas due to underdeveloped tear glands
What are the purposes of the eyelids?
-protect the globe
-distribute the tear film
What is the physiology of the eyelids?
-upper lid is more mobile in most mammals
-closure occurs from lateral to medial to spread tears and direct them into nasolacrimal puncta
-limits entry of light into the eye
-protects globe via reflexes
What is distichia?
-cilia originating from the tarsal gland that emanate from the tarsal gland opening on eyelid margin
-often present without disease
-can prevent ulcer healing
What are the treatment options for distichia?
-freezing of the cilia with a double freeze/thaw cycle
-pulling of the cilia (temp. solution)
-no action (most are asymptomatic)
What is trichiasis?
normal hair that rubs the cornea; often seen with prominent facial folds or aberrant dermis
What are the treatment options for trichiasis?
-train hair away with petroleum jelly
-pocket medial canthoplasty
-facial fold resection
What is ectropion?
eversion of the eyelid
What are the signs of ectropion?
-eyelid eversion
-chronic conjunctivitis
-ocular discharge
-possible keratitis
What are the treatment options for ectropion?
-no action (only treated when keratitis occurs)
-intermittent topical corticosteroids
-modified Kuhnt-Symanowski procedure/wedge resection
What is pagoda lid?
combination of entropion medially and laterally with ectropion in the center of the eyelid
What is lagophthalmia?
-failure to blink completely
-due to facial nerve paralysis or conformational problem in brachycephalics
What is the treatment option for lagophthalmia?
-medial canthoplasty to shorten palpebral fissure
-allows each blink to cover more of the cornea and reduce the lagophthalmia
What is medial aberrant dermis?
-small piece of dermis in the medial canthus of the eye that often has emanating hairs
-dermis and hairs irritate the nasal aspect of the cornea and can cause pigmentation
What is the treatment option for medial aberrant dermis?
medial canthoplasty
What is ophthalmia neonatorum?
infection (typically Staph) under the fused eyelids prior to the eyelids opening that causes swollen lids +/- purulent exudate
What are the treatment steps for ophthalmia neonatorum?
-splitting of the lid margin with blunt scissors
-flushing of the conjunctiva
-topical antibiotic based on C&S
-ulcer treatment if present
What is chalazion?
-granulomatous inflammation of the tarsal gland(s)
-localized mass beneath conjunctival surface
What is the appearance of chalazion?
-mass on outside
-abscess on conjunctival side
What are the treatment steps for chalazion?
-warm compresses
-topical antibiotics or dexamethasone
-lance via conjunctiva
-curette
What are the characteristics of eyelid neoplasia?
-tarsal gland adenoma is most common
-majority of tumors are benign
-can see papillomas and melanomas
-malignancies such as mast cell tumors, squamous cell carcinoma, hemangiosarcoma, and fibrosarcoma can occur
-side effects include abnormal lid function, keratitis, conjunctivitis, and superficial ulcers
How is eyelid neoplasia diagnosed?
biopsy
What are the characteristics of eyelid neoplasia treatment?
-1/3 of the eyelid margin can safely be removed without decreasing function
-blepharoplastic procedures done if more than 1/3 of eyelid margin is removed
-small tumors are removed via wedge resection or pentagonal excision
-closure of the margin is done with figure-8 suture to prevent corneal irritation and/or ulceration
What are the characteristics of eyelid lacerations?
-perform minimal to no debridement due to tremendous blood supply
-immediate repair is crucial to preventing tissue loss
-figure-8 margin sutures placed first
-two layer closures are done for long lacerations
-must ensure no sutures penetrate the conjunctiva
