The document discusses several common eyelid conditions including hordeolum, chalazion, xanthelasma, eyelid retraction, blepharoptosis, epicanthus, blepharitis, entropion, and trichiasis. It provides details on signs, classifications, causes, and treatment options for each condition.
The document discusses several common eyelid conditions including hordeolum, chalazion, xanthelasma, eyelid retraction, blepharoptosis, epicanthus, blepharitis, entropion, and trichiasis. It provides details on signs, classifications, causes, and treatment options for each condition.
The document discusses several common eyelid conditions including hordeolum, chalazion, xanthelasma, eyelid retraction, blepharoptosis, epicanthus, blepharitis, entropion, and trichiasis. It provides details on signs, classifications, causes, and treatment options for each condition.
The document discusses several common eyelid conditions including hordeolum, chalazion, xanthelasma, eyelid retraction, blepharoptosis, epicanthus, blepharitis, entropion, and trichiasis. It provides details on signs, classifications, causes, and treatment options for each condition.
Download as PPT, PDF, TXT or read online from Scribd
Download as ppt, pdf, or txt
You are on page 1/ 37
TUMOR MATA
Dr. H. Ibrahim, SpM(K)
Hordeolum • An acute infection (usually staphylococcal) can involve the sebaceous secretions in the glands of Zeis (external hordeolum, or stye) or the meibomian glands (internal hordeolum) • External hordeola, the infection often appears to center around an eyelash follicle, and the eyelash can be plucked to promote drainage • Spontaneous resolution often occurs TREATMENT : • Application of hot compresses and topical antibiotic ointment is usually curative Complication : • May progress to true superficial cellulitis, or even abscesses of the eyelid systemic antibiotic therapy and possible surgical incision and drainage may be required. Chalazion
is a focal inflammation of the eyelids that
results from an obstruction of the meibomian glands often associated with rosacea and chronic blepharitis. occasionally be confused with a malignant neoplasm. SIGNS : • acute inflammatory response accompanied by pain and erythema of the skin • Most Common bacterial agents : Staphylococcus aureus • Histologically, these lesions are characterized by chronic lipogranulomatous inflammation. TREATMENT : • Acute inflammatory phase Warm compresses and appropriate eyelid hygiene. Topical antibiotic or anti-inflammatory ocular medications can be used. • Acute secondary infection may be treated with an antibiotic directed at skin flora • Doxycycline or tetracycline (for a case requires long-term suppression of meibomian gland inflammation associated with ocular rosacea). • Chronic Calazion : surgery (incision) Xantelasmas Are yellowish plaques that occur commonly in the medial canthal areas of the upper and lower eyelids Signs : They represent lipid-laden macrophages in the superficial dermis and subdermal tissues. Sometimes associated with hypercholesterolemia or congenital disorders of lipid metabolism. Sometimes reccurence • Treatments : • Excision • Other treatment options: serial excision, C02 laser ablation, or topical 100% trichloroacetic acid. Deep extension into the orbicularis muscle can occur, in which case the lesion may not be amenable to surface ablative therapies. • Complication : cicatricial ectropion Eyelid Retraction
• Eyelid retraction is present when the upper
eyelid is displaced superiorly or the lower eyelid inferiorly, exposing sclera between the limbus and the eyelid margin • Complications : lagophthalmos and exposure keratitis ocular irritation and discomfort to vision-threatening corneal decompensation. Causes : Local, systemic, or central nervous • Most Common : Tiroid eye disease (TED), recession of the vertical rectus muscles, overly aggressive skin excision in blepharoplasty, and overcompensation for a contralateral ptosis Treatment : Based on the underlying etiologic factors. • Symptomatic (Artificial tears, lubricants, and ointments to protect the cornea and minimize symptoms in cases of mild eyelid retraction). Blepharoptosis
• blepharoptosis, to describe drooping or
inferodisplacementof the upper eyelid • Classification : Congenital and Acquired Physical examination of the ptosis patient begins with 5 clinical measurements: • margin- reflex distance • vertical palpebral fissure height • upper eyelid crease position • levator function (upper eyelid excursion) • Presence of lagophthalmos Classification
Myogenic ptosis • Congenital myogenic ptosis results from dysgenesis of the levator muscle. • Acquired myogenic ptosis is uncommon and results from localized or diffuse muscular disease such as muscular dystrophy, chronic progressive external ophthalmoplegia, MG, or oculopharyngeal dystrophy Aponeurotic ptosis The levator aponeurosis transmits levator force to the eyelid. Thus, any disruption in its anatomy or function can lead to ptosis. Neurogenic ptosis • Congenital conditions Congenital neurogenic ptosis is caused by innervational defects that occur during embryonic development. • Acquired conditions Acquired neurogenic ptosis results from interruption of normally de- veloped innervation and is most often secondary to an acquired CN III palsy, to an ac- quired Horner syndrome, or MG. Mechanical ptosis • Mechanical ptosis usually refers to the condition in which an eyelid or orbital mass weighs or pulls down the upper eyelid, resulting in inferodisplacement. Traumatic ptosis • Trauma to the levator aponeurosis or the levator muscle may also cause ptosis through myogenic, aponeurotic, neurogenic, or mechanical defects Pseudoptosis • apparent eyelid drooping-should be differentiated from true ptosis. • An eyelid may appear to be abnormally low in various conditions, including hypertropia, en- ophthalmos, microphthalmia, anophthalmia, phthisis bulbi, or a superior sulcus defect secondary to trauma or other causes • MANAGEMENT : 3 categories of surgical procedures most commonly used in ptosis repair: • external (transcutaneous) levator advancement • internal (transconjunctival) levator/tarsus/Muller muscle resection approaches • frontalis muscle suspensions Epichantus • Epicanthus is a medial canthal fold that may result from immature midfacial bones or a fold of skin and subcutaneous tissue • The condition is usually bilateral • An affected child may appear esotropic because of decreased scleral exposure nasally (pseudostrabismus) 4 types of epicanthus : • epicanthus tarsalis if the fold is most prominent in the upper eyelid • epicanthus inversus if the fold is most prominent in the lower eyelid •epicanthuspalpebralisifthefoldisequallydistribu tedintheupperandlowereyelids • epicanthus supraciliaris if the fold arises from the eyebrow region running to the lacrimal sac • Epicanthus tarsalis can be a normal variation of the Asian eyelid, whereas epicanthus in- versus is frequently associated with blepharophimosis syndrome Treatment : • Most forms of epicanthus resolve with normal growth of the facial bones • If no associated eyelid anomalies are present, observation is recommended until the face achieves maturity. • linear revisions such as Z-plasty or Y-V-plasty Blepharitis • Seborrheic Blepharitis • CLINICAL PRESENTATION may occur alone or in combination with staphylococcal blepharitis or MGD • Inflammation occurs primarily at the anterior eyelid margin a variable amount of crusting, typically of an oily or greasy consistency, may be found on the eyelids, eyelashes, eyebrows, and scalp. • Signs and symptoms include chronic eyelid redness, burning, and, occasionally, foreign-body sensation. A small percentage of patients MANAGEMENT • Eyelid hygiene is the primary treatment for seborrheic blepharitis • Treatment that associated MGD or staphylococcal blepharitis • selenium sulfide shampoos is recommended • Staphylococcal Blepharitis • Caused usually by Staphylococcus aureus but occasionally by other species refers to cases in which bacterial infection of the eyelids (and frequently the conjunctiva) is predominant. MGD and seborrheic blepharitis, in contrast, are primarily inflammatory. Symptoms • Burning, itching, foreign-body sensation, and crusting, particularly upon awakening. • Symptoms of irritation and burning tend to peak in the morning and improve as the day progresses, presumably as the crusted material that accumulates on the eyelid margin overnight. MANAGEMENT : • Eyelid hygiene, with either commercially available eyelid scrub kits or warm water with diluted baby shampoo • antibiotic solution. • Anti- inflammatory Entropion
• Entropion is an inversion of the eyelid margin
• Lower eyelid entropion (usually involutional) is much more common than upper eyelid entropion (usually cicatricial) • Can be unilateral or bilateral Classification : • congenital • acute spastic • involutional • cicatricial • Congenital Entropion Developmental factors : lower eyelid retractor dysgenesis, structural defects in the tarsal plate, and relative shortening of the posterior lamella • Acute Spastic This condition follows ocular irritation or inflammation. It occurs most commonly after intraocular surgery in patients who had unrecognized or mild involutional eyelid changes preoperatively • Involutional Entropion Usually occurs in the lower eyelids. Predisposission Factors : tissue atrophy with horizontal laxity of the eyelid, attenuation or disinsertion of eyelid retractors, and overriding by the preseptal orbicularis • Cicatricial caused by vertical tarsoconjunctival contracture and inter- nal rotation of the eyelid margin, with resulting irritation of the globe from inturned cilia or the keratinized eyelid margin Trichiasis
