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Year 1/2 > Cognition & Senses 2: Eyelids > Flashcards

Cognition & Senses 2: Eyelids Flashcards

1
Q

PALPEBRAE definition

A

= EYELIDS

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2
Q

BLEPHARON definition

A

= EYELIDS

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3
Q

ADNEXA definition

A

= TISSUES around the eye, including the LIDS & SKIN within 1 CM around the eye

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4
Q

which MUSCLE in the eye is primarily involved in BLINKING?

what CRANIAL NERVE innervates it?

A

ORBICULARIS OCULI

innervated by FACIAL nerve (CN VII)

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5
Q

animals tend to have CILIA only on…

A

THE UPPER EYELID

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6
Q

name 3 functions of the EYELIDS?

A
  1. PROTECTION of the eye & MAINTENANCE of OCULAR SURFACE HEALTH
  2. BLINKING to ENTRAP/REMOVE DEBRIS & help with TEAR FILM DISTRIBUTION
  3. GLANDULAR SECRETIONS of LIPID portion of the PRE-CORNEAL TEAR FILM to give NUTRITION to CORNEA & OCULAR SURFACE
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7
Q

LAGOPHTHALMOS definition

this is seen frequently in WHAT BREEDS of dog?

A

INABILITY to CLOSE THE EYELIDS over the GLOBE OF THE EYE

frequent in SMALL BREEDS that have EXOPHTHALMOS

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8
Q

MOST of the eyelid disease that we see is ___

A

SURGICAL

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9
Q

how LONG does it take for EYES TO OPEN IN DOGS/CATS?

what if the lids open PREMATURELY?

what if the lids DO NOT OPEN? (name the term & clinical signs)

A

how LONG? = 10-14 days in DOGS/CATS

lids open PREMATURELY…
= DAMAGE TO THE OCULAR SURFACE

lids DO NOT OPEN = OPHTHALMIA NEONATORUM, causing CONJUNCTIVITIS/INFECTION

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10
Q

in SMALL ANIMAL PRACTICE, we MAINLY see eye diseases that affect the ____ ____, which can result in ____ ____ disease, such as… (2)

A

EYELID MARGIN, OCULAR SURFACE disease, such as…
1. CORNEAL ULCERS
2. SCARRING

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11
Q

what are the 4 main CATEGORIES of EYE DISEASE we’ll see in small animal practice?

A
  1. EYELID MARGIN INTEGRITY
  2. MEIBOMIAN GLANDS (tarsal glands)
  3. PERIOCULAR SKIN
  4. BLINKING
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12
Q

4 most common DISEASES that COMPROMISE eyelid margin integrity

A
  1. TRAUMA causing EYELID LACERATION (ex = running through bushes)
  2. CONFORMATIONAL/BREED-RELATED from ENTROPION
  3. EYELID NEOPLASMS
  4. DEVELOPMENTAL abnormalities where PARTS OF EYELID ARE ABNORMAL or MISSING
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13
Q

TRAUMA to the EYELIDS…

requires what 2 things? why?

what is the GOAL? why?

A

requires…
1. SURGERY
2. REPAIR ASAP

why? –> if the eye is left to heal on its own by SECONDARY INTENTION, could cause FIBROSIS & IRREGULAR EYELID MARGIN leading to OCULAR DZ

GOAL = to RESTORE SMOOTH EYELID MARGIN

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14
Q

EYELID SURGERY…

how does the eye tend to heal? risk of infection?

what 4 things are REQUIRED to do the surgery?

how do PREP around the eye?

A

eye tends to heal QUICKLY due to GOOD BLOOD SUPPLY & LOW RISK OF INFECTION

what 4 things are REQUIRED to do the surgery?
1. good MAGNIFICATION 2-4 X
2. HIGH INTENSITY, FOCAL LIGHT
3. SMALL SUTURE often VICRYL (absorbable) or SILK (needs to be removed)
4. APPROPRIATE INSTRUMENTATION specific for eyelids

PREP = must use DILUTE BETADINE, we CANNOT USE ALCOHOL OR CHLORHEXIDINE because it can CAUSE A CORNEAL ULCER

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15
Q

SURGICAL RESTORATION of EYELID MARGIN…

3 steps?

A

steps?
1. put SUTURE THROUGH MEIBOMIAN GLANDS in a FIGURE-8 SUTURE to KEEP KNOT AWAY FROM EYE

  1. close the wound at eyelid margin in 2 LAYERS
  2. use SIMPLE INTERRUPTED sutures to FINISH THE WOUND
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16
Q

POST-OP CARE for EYELID SURGERY? (3)

if you use APPROPRIATE SURGICAL TECHNIQUE, MOST patients…

A
  1. E-COLLAR for 14 DAYS (or until suture removal)
  2. TOPICAL ANTIBIOTICS/ANTI-INFLAMMATORY (NeoPolyDex) for 14 DAYS
  3. EXERCISE RESTRICTION for 1-2 WEEKS

if you use APPROPRIATE SURGICAL TECHNIQUE, MOST patients have a GOOD OUTCOME

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17
Q

ENTROPION vs. ECTROPION?

what PART of the eyelid can be affected?

which one is MORE LIKELY to cause TEARING?

A

ENTROPION = eyelid margin ROLLING INTO EYE (more common)
–> MORE LIKELY TO CAUSE TEARING

ECTROPION = ROLLING OUT of the EYELID MARGIN

ONE or BOTH parts of the eyelid can be affected

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18
Q

ID LESION

A

ENTROPION

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19
Q

ID LESION

A

ECTROPION

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20
Q

ENTROPION…

3 causes?

if you apply TOPICAL ANESTHESIA to the eye, WHICH of the causes will see RESOLUTION?

A

3 causes?
1. PRIMARY = common in SOME BREEDS
–> Shar Peis
–> Bulldogs

  1. SPASTIC = CHRONIC SQUINTING causes EYE to be PULLED IN
  2. CICATRICAL ENTROPION = from CHRONIC SPASTIC ENTROPION causing SCARRING TO EYE

if we give TOPICAL ANESTHESIA, then SPASTIC & CICATRICAL ENTROPION will be RESOLVED!

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21
Q

BLEPHAROSPASM DEFINITION

A

SQUINTING

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22
Q

EPIPHORA definition

A

when TEARS SPILL OVER THE LIDS from EXCESSIVE TEAR PRODUCTION

23
Q

TRICHIASIS definition

A

= NORMAL HAIRS that are GROWING TOWARDS THE EYE & PUSHING ON IT

24
Q

KERATITIS definition

if it’s LONG-TERM, can cause formation of ____ ____

A

= INFLAMMATION of the CORNEA

if it’s LONG-TERM, can cause formation of GRANULATION TISSUE

25
Q

PTOSIS definition

can sometimes SECONDARILY cause ___

A

= when the UPPER EYELID starts to SAG

can can sometimes SECONDARILY cause TRICHIASIS (normal eyelashes touching surface of eye)

26
Q

TREATMENT for ENTROPION…

what 4 CLINICAL SIGNS do we need to address?

treatment depends on…

3 options?

A

4 signs?
1. TRICHIASIS
2. PAIN
3. TEARING
4. CORNEAL IRRITATION

treatment depends on the AGE of the ANIMAL / COMPLEXITY

3 options?
1. PUPPY = TEMPORARY TACK around the eye, sometimes FOLDS CAN EVEN OUT WITH AGE

  1. if MILD = LUBRICATION BID to act as BARRIER between HAIRS & EYE SURFACE
  2. if MODERATE to SEVERE = SURGERY
27
Q

SURGERY for ENTROPION…

we should choose the ___ TECHNIQUE to CORRECT THE PROBLEM

most commonly we use WHAT technique? (2 names)

A

we should choose the SIMPLEST TECHNIQUE to CORRECT THE PROBLEM

most commonly, we use the HOTZ-CELSUS or SMILE technique

28
Q

HOTZ-CELSUS surgical technique…

used to treat WHAT?

5 steps?

A

used to treat ENTROPION surgically

steps?
1. STABILIZE LID

  1. mark 2 LINES
    –> one a couple mm from EYELID MARGIN that spans LENGTH OF ENTROPION
    –> another HOW FAR YOU WANT TO ROLL OUT THE LID
  2. make 2 INCISIONS with a BLADE at MARK
  3. REMOVE SKIN ONLY with SCISSORS
  4. close with ONE LAYER of SUTURE
29
Q

EYELID NEOPLASMS…

commonality?

diffuse vs. focal?

often originates from the ___ ___ & causes SECONDARY ___ from…

MOST of what we see are ____ _____ _____ in DOGS

CATS vs. DOGS?

A

VERY COMMON

usually FOCAL

often originates from the MEIBOMIAN GLAND & causes SECONDARY CHELAZIAN from SECONDARY SWELLING OF GLAND bc LIPID PRODUCT CANNOT ESCAPE

MOST of what we see are MEIBOMIAN GLAND ADENOMAS in DOGS

DOGS = usually BENIGN
CATS = often AGGRESSIVE

30
Q

what EYELID NEOPLASMS can we commonly see in CATS? (2)

A
  1. SQUAMOUS CELL CARCINOMA
  2. MAST CELL TUMORS
31
Q

ID LESION

A

MEIBOMIAN GLAND ADENOMA

32
Q

TREATMENT for EYELID NEOPLASM…

depends on… (3)

___ is usually required

A

depends on…
1. CLINICAL SIGNS –> is it bothering the pet?
2. TUMOR TYPE
3. COST of tx

SURGERY is USUALLY REQUIRED

33
Q

ID LESION (2 possibilities)

what is the PROGNOSIS for this?

common in WHAT AGE dogs?

A

HISTIOCYTOMA or PAPILLOMA

prognosis is GOOD, these USUALLY REGRESS

common in YOUNG DOGS

34
Q

SURGERY for SMALL EYELID TUMOR…

usually perform a ____ ____

4 steps?

what is ONE REQUIREMENT to even do this procedure?
–> what do we need to do?

A

usually perform a WEDGE RESECTION

steps?
1. make 2 INCISIONS on EITHER SIDE OF MASS at RIGHT ANGLES TO LID MARGIN
2. make a HOUSE-SHAPED INCISION so that LOWER-LID DOES NOT PUCKER
3. close in 2 LAYERS with 4-0 to 6-0 VICRYL (WEDGE and FIGURE OF 8)
4. submit for PATHOLOGY

the MASS must be <1/3 EYELID MARGIN LENGTH or else WILL NOT BE ABLE TO CLOSE EYE UPON REMOVAL
–> we need to MEASURE BEFOREHAND

35
Q

TREATMENT for LARGE EYELID TUMOR…

= define WHAT a large eyelid tumor is

what DIAGNOSTIC procedure can we perform?

if we need to treat SURGICALLY…

A

= >1/3 EYELID LENGTH

diagnostic? = FNA if POSSIBLE!

if we need to treat SURGICALLY, might need RECONSTRUCTIVE PROCEDURE/SKIN GRAFT, so REFER OUT!

36
Q

EYELID AGENESIS…

“aka?”

= definition & etiology

common in WHAT species?

causes what 3 clinical signs?

2 treatment goals?

A

aka “COLOBOMA”

= INCOMPLETE LATERAL UPPER EYELID MARGIN & CONJUNCTIVA that has CONGENITAL ORIGIN

3 clinical signs..
1. TRICHIASIS
2. TEARING
3. CHRONIC EXPOSURE KERATITIS

2 treatment goals?
1. RESOLVE TRICHIASIS
2. create SMOOTH EYELID MARGIN

37
Q

ID DZ (2 names)

A

EYELID AGENESIS / COLOBOMA

38
Q

what is the SURGICAL TREATMENT for EYELID AGENESIS / COLOBOMA?

what can be CHALLENGING about treating this?

A

use ROTATIONAL SKIN FLAPS to move SKIN FROM BELOW to TOP TO RECREATE EYELID MARGIN

difficult to RESTORE INTEGRITY OF EYELID MARGIN (close tightly)

39
Q

DERMOID…

= definition

commonality?

tx?

A

= HAIR GROWING in ABNORMAL PLACE

UNCOMMON

tx = SURGICAL RESECTION

40
Q

ID LESION

A

DERMOID

41
Q

DISTICHIASIS

= definition

commonality?

unilateral vs. bilateral?

3 clinical signs?

A

= ABERRANT CILIA that GROW from the MEIBOMIAN GLANDS due to ABNORMAL DEVELOPMENT

COMMON

usually BILATERAL

3 clinical signs?
1. INCREASED BLINKING
2. BLEPHAROSPASM (squinting)
3. TEARING

42
Q

ID LESION & define

A

DISTICHIASIS

ABERRANT CILIA grow out of MEIBOMIAN GLANDS

43
Q

ID LESION

A

DISTICHIA

44
Q

ECTOPIC CILIA…

= definition

commonly also have WHAT secondary condition?

2 clinical signs? 1 signalment?

A

= CILIA that emerge THROUGH PALPEBRAL CONJUNCTIVA to TOUCH CORNEA

commonly also have DISTICHIASIS

2 clinical signs?
1. PAINFUL EYE
2. RECURRENT CORNEAL ULCERS

1 signalment = YOUNG DOGS

45
Q

TREATMENT for DISTICHIASIS…

most commonly? what is the procedure?

2 benefits?

2 risks? both are +/-

A

MOST COMMONLY = use CRYOTHERAPY to FREEZE MEIBOMIAN GLAND & DESTROY FOLLICLE

2 benefits?
1. SPARES the NORMAL tissue
2. PRESERVES EYELID MARGIN

2 risk?
+/- DEPIGMENTATION
+/- REGROWTH of hairs, but usually come back SOFTER

46
Q

TREATMENT for ECTOPIC CILIA? (2)

A
  1. EXCISE the ABERRANT HAIRS
  2. use CRYOTHERAPY to REMOVE
47
Q

CHALAZION…

= definition

2 common etiologies?

2 treatment options?

A

= LIPID in the MEIBOMIAN GLAND causing INFLAMMATION

2 common etiologies?
1. ATOPY (allergy)
2. EYELID TUMORS that are BLOCKING EXIT OF LIPID SECRETIONS

treatment?
1. WEDGE RESECTION to remove
2. use BLADE to EXCISE then CRYOTHERAPY

48
Q

ID LESION

A

CHALAZION

49
Q

BLEPHARITIS

= definition

causes WHAT 4 CLINICAL SIGNS?

clinical approach? (overall and 4 subs)

surgery?

A

= ANY SWELLING of EYELIDS

4 signs?
1. MARKED LID HYPEREMIA & EDEMA
2. PAIN
3. TEARING
4. SELF-TRAUMA (alopecia, erosions)

clinical approach? = DIAGNOSTICS to DETERMINE CAUSE, so CLIP & CLEAN then…
1. SKIN SCRAPE
2. C&S
3. CYTOLOGY
4. TRICHOGRAM

NO SURGERY

50
Q

ID CLINICAL SIGN

A

BLEPHARITIS

51
Q

7 possible ETIOLOGIES for BLEPHARITIS?

A
  1. BACTERIAL infection
  2. SEBACEOUS OVERPRODUCTION
  3. DEMODEX & SCABIES
  4. IMMUNE-MEDIATED
  5. DRUG RXN
  6. FOOD ALLERGY
  7. ACTINIC KERATOSIS (sun-related injury)
52
Q

PUPPY STRANGLES..

aka?

= definition

3 tx?

if this is NOT RESOLVED…

common in WHAT patients? with WHAT?

A

aka BACTERIAL BLEPHARITIS

= STAPHYLOCOCCAL INFECTION around the EYELID

3 tx?
1. ANTIBIOTICS
2. ORAL PREDNISONE
3. TOPICAL ANTIBIOTICS & ANTI-INFLAMMATORIES via EYE DROPS

if NOT RESOLVED, can cause CICATRICAL ENTROPION from EYELID DISTORTION

common in WHITE FLUFFY DOGS with ATOPY

53
Q

SURGICAL TREATMENT for ____ BREED with LAGOPHTHALMOS? (3 words, & define what it does)

is this always done?

A

BRACHYCEPHALIC BREED

= PERMANENT MEDIAL CANTHOPLASTY, helps to MAKE THE MEDIAL EYELID SMALLER

NOT ALWAYS DONE, can try LUBRICATING EYE REGULARLY

Year 1/2 (139 decks)

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