Q1 - Disorders Of Eyelids

Question 1

Developmental anomalies

Answer 1

1. Coloboma-> unilateral triangular defect (hole) usually of upper eyelid.
2. Epicanthal folds -> bilateral skin fold covering medial angle of eye. Asians, downs.
3. Blepharophimosis -> shortening of horizontal palpebral fissure.
4. Ankyloblepharon -> horizontal shortening of palpebral fissure + fusion eyelids in lateral &a medial angles.

Question 2

Deformities

Answer 2

Ptosis, Entropion, Ectropion, Trichiasis, Blepharospasm

Question 3

Ptosis

Answer 3

• drooping of upper eyelid, due to levator palpebrae paralysis.
  1. Congenital -> aplasia of oculomotor nerve, or underdeveloped muscle
  2. Acquired -> neurogenic (oculomotor palsy, Horner’s palsy w/ simp nerve lesion), myotonic (myasthenia Gravis) or traumatic.

Question 4

Entropion

Answer 4

• inwards folding of eyelid (lower usually). Skin&lashes rub against conjunctiva -> irritation.
  1. Congenital -> thickening of skin&orbicularis oculi muscle
  2. Spastic -> laxation of structure in old age, or atrophy of orbital fatty tissue.
  3. Cicatricial -> post-infectious/traumatic tarsal contractures

Question 5

Ectropion

Answer 5

• Lower eyelid turns outwards.
  1. Congenital -> rare, usually in other congenitals involving face or eyelids.
  2. Senile -> ligaments&tarsal plate lax with age
  3. Paralytic -> facial paralysis w loss of orbicularis oculi function
  4. Cicatricial -> after infection or injury

Question 6

Trichiasis

Answer 6

• postinfectious/traumatic inward turning of eyelashes -> permanent foreign body sens, tear secretion and chronic conjunctivitis.

Question 7

Blepharospasm

Answer 7

• Spasmodic contraction of orbicularis oculi due to inflamm of ant chamber, encephalitis or MS.

Question 8

Disorders of skin & eyelid margins

Answer 8

1. Contact eczema - allergic reddening swelling and itching
2. Edema - infections or allergic
3. Blepharitis - scaly inflamm of eyelid margins
4. Herpes simplex of eyelids - eruptions of painful vesicles that later dry and crusts.
5. Herpes zoster ophthalmicus - VZV. Facial rash, vesicles and pain.
6. Eyelid abscesses - collections of pus + inflame and swelling. Due to minor trauma, insects or spread of inflame from paranasal sinuses.

Question 9

Disorders of eyelid glands

Answer 9

1. Hordeolum - acute bacterial infection of eyelid glands. Swelling w pus.
2. Chalazion - firm nodular bulb within tarsus. Due to chronic inflammation due to buildup of secretions from tarsal glands.