2: eyelids - pearce Flashcards Preview

IP 11 Ophthalmology > 2: eyelids - pearce > Flashcards

Flashcards in 2: eyelids - pearce Deck (67):
1

what are the components of the eyelid?

- skin
- sub Q CT
- orbicularis oculi
- tarsal glands
- tarsal plate
- conjunctiva
- cilia

2

what are the functions of the eyelid?

- protection
- tear film production, distribution, and drainage
- oxygen exchange [conjunctiva]

3

what type of muscle is the orbicularis oculi muscle?

why is its action atypical for similar muscles of this type?

sphincter M

there are medial and lateral ligg, temporal and nasal ligg that modify its sphincter action

4

what is the function of the orbicularis oculi muscle?

to open and close the eyelids

5

what is the tarsal plate?

tissue associated w glands that is often very firm

very well developed in humans

6

what do the tarsal glands produce?

fat and oil - one component of the tear film

7

what is the palpebral conjunctiva?

the tissue on the inner surface of the eyelid

8

what does the conjunctiva produce?

specifically, what structure produces this?

the mucus portion of the tear film

prod by goblet cells in the conjunctiva

9

what are cilia?

eyelashes

10

what do lacrimal glands produce?

aqueous components of tear film

11

what is ankyloblepharon?
etiology?

delayed / incomplete eyelid opening - congenital

often accompanied by mucopurulent discharge

12

at what age in dogs/cats do the eyes typically open?

10-15 days old

13

what is the etiology of the mucopurulent discharge associated with ankyloblepharon in dogs?

and in cats?

dogs: Staphylococcus spp

cats: Chlamydophila or FHV-1

14

what is often the origin of the BacT under the eyelids in puppies and kittens with ankyloblepharon?

a staph infection in the uterus during the pregnancy - causes the eyelids to remain shut

15

t/f

if a client reports their newborns have closed eyes and discharge coming from them, the case can wait until Monday

false

the case is an emergency - see animals ASAP

16

tx of ankyloblepharon?

- warm compress with digital pressure

- blunt dissection to help open the eyes - start at medial area of eye b/c the 3rd eyelid is there for a layer of protection during your dissection

17

t/f

careful sharp dissection is appropriate for ankylolepharon

false

blunt dissection only

18

what is eyelid agenesis?
what is another name for it?

partial palpebral fissure absence
"coloboma"

19

is eyelid agenesis MC in dogs or cats?

cats - esp wild cats, such as snow leopards

20

what does eyelid agenesis look like?

normal eyelid margin is not present in some areas along the border of the eyelid - conjunctiva goes directly into the skin in these areas

MC lateral portion of upper eyelid is affected

21

what are the consequences of eyelid agenesis?

there are exposed areas when the animal blinks - poor protection and lubrication in that area of the eye

- inability to blink normally
- exposure keratitis
- conjunctivitis
- other congenital ocular dzz often accompany this

22

what is posterior segment coloboma?

holes in the tissue of the posterior segment - often accompanies eyelid agenesis

23

what are some other congenital ocular dzz that accompany eyelid agenesis?

dermoids

[she said to look in the text for a more detailed list of dzz that are found with this and this was the only one listed - so idk if its for a test questions or for our own knowledge...]

24

t/f

eyelid agenesis does not always impair vision

true

may or may not affect vision

25

one common surgical treatment for eyelid agenesis?

pedicle graft flap, from the lower portion of the lid over the area - delicate sx so should refer this case

26

what is a choristoma?

normal tissue in an abnormal location

27

what is a dermoid?

a type of choristoma - specifically a choristoma loc on the eye

many dermoids tend to grow hair

28

dermoid tx?

- dep on size, loc, visual impairment
- resection (may be indicated)
- +/- skin or conjunctival grafts

29

what are 3 common eyelash disorders

what species are they MC in?

trichiasis
distichiasis
ectopic cilia

MC in dogs

30

what is trichiasis?

normal hair on the eyelid that contacts the corneal surface

may cause some pigmentation and irritation

relatively benign condition

MC in small white fluffy dogs with fine hair

31

what is distichiasis?

what does it commonly cause?

a hair follicle starts in the Meibomian gland and extends through the duct of the gland, through the central part if the eyelid margin

usually more sharp hair then in trichiasis

can cause corneal ulcer - definitely corneal irritation

32

what is ectopic cilia?

what does it commonly cause?
classic presentation?

a hair follicle originates the the Meibomian gland and goes through the palpebral surface of the eyelid

very nasty - causes corneal ulcers, pain, epiphora, blepharospasm

often seen in young dogs with UNCER LOC IN CENTRAL UPPER EYELID, DORSAL PART OF CORNEA

33

what is the typical presentation of a traumatic corneal ulcer?

in the center of the cornea

34

which eyelash disorder is most common in horses?

- acquired trichiasis, post trauma

35

what are treatment options for distichia?

electroepilation and cryoepilation

36

which treatment option for distichia is most conventional and more widely used?

cryoepilation

37

how does cryoepilation work?

what is one consideration to take when using this method?

- used for many distichia

- freeze eyelid on each side - 2 freeze thaw cycles - follicle is killed so hairs may fall out or manually pull them out

- intense swelling and depigmentation of lid margin occurs [temporarily]

- the freezing will inhibit tissue healing so do not perform at the time of other ocular surgery, or if you do, be careful how liberal your margins of freezing re

38

t/f

the purpose of the cryoepilation procedure is to efficiently get rid of all distichia bothering the animal in one procedure

false

goal is to reduce the load and make the animal more comfortable, not to remove every distichia on the eyelid - patient may need another procedure if there are many distichia

39

what is the Tx for ectopic cilia?

excision and cryoepilation

40

what is the Tx for trichiasis?

none if asymptomatic

clip hair short
Sx rarely necessary

41

what syndromes are part of brachycephalic ocular syndrome?

- macropalpebral fissures
- medial trichiasis
- medial lower lid entropion
- pigmentary keratitis
- nasal trichiasis

42

tx for brachycephalic ocular syndrome?

medial canthoplasty - for young dogs with excessive corneal exposure and excessive pigmentation

[essentially, is a form of plastic surgery - improves comfort for dog]

- cyclosporin and meds to dec irritation and inc tear production

43

what is entropion?

conformation eyelid abnormality

eyelid inversion

44

what is ectropion?

conformational eyelid abnormality - eyelid eversion

45

what is lagophthalmos?

inability to completely blink due to conformational eyelid abnormality

MC in brachycephalics

46

what is combined entropion-ectroption disorder?

common name?

"diamond eye" - eyelid is inverted and everted in various locations around eyelid

2* to excessive eyelid length [euryblepharon]

common in bloodhounds, st bernards, clumber spaniel

47

what are the etiologies of entropion?

- congenital / genetic
- spastic
- cicatricial

48

what is spastic entropion?

eyelids touch cornea - very painful -> eyelids roll in further -> vicious cycle exacerbated

49

what is cicatricial entroption?

MC in what species?

fibrosis 2* to chronic spastic entropion -> trauma -> irritation

common in cats [often assoc w herpes infection]

50

feline entropion in young cats is MC 2* to whaat conditions?

2* to conjunctivitis and corneal ulceration [spastic]

conjunctivitis MC, cicatricial

51

feline entropion in old cats is due to?

lid laxity
globe enophthalmos

often lose weight so lose fat -> lose orbital volume

52

feline entropion in Persian cats is due to?

brachycephalic anatomy

53

feline entropion in Maine Coone cats is due to?

Large jowls

54

what is a very important thing to do accurately prior to sx correction of entropion?

get rid of spastic component to measure - add topical anesthetic to eye the measure the tissue with the eye fully open

DO NOT take too much tissue out or you will cause more problems -> do not over correct and you cannot put tissue back in later once you take it out

55

when is eyelid tacking performed?

after animal is skelatelly mature
if done on puppies, it is temporary
often in Shar pei's

56

what are entropion tx options?

Hotz-Celsus procedure
- get rid of spastic component
- measure skin to take out using calipers
- close using "law of bisection" to ensure good physiologic flap of skin makes the closure clean

57

what occurs if you over correct during entropion sx?

you cause ectropion

58

what are principles of repair as per Wedge Resection for simple eyelid lacerations?

- less than 1/3 eyelid margin lost
- 2 layer closure
- margin apposition critical [figure of 8 suture good for good tissue apposition]

59

what is the 2 layer closure procedure during ectropion correction and eyelid laceration repair?

1. subQ interrupted suture
2. figure 8 suture
3. simple interrupted skin suture

60

what is blepharitis?

eyelid inflammation

61

differentials for blepharitis?

infectious [bacT, fungal, parasitic]

immune mediated [allergic or vesicularbullous dzz]

other: solar, foreign body, self trauma

62

how to work up blepharits?

eyelid scrape
pluck hair
smear on slide and look at tissue

63

what is typical of eyelid tumors in dogs?

benign adenomas [80% benign]

64

what is typical of eyelid tumors in cats and cattle?

SCC

65

what is typical of eyelid tumors in horses?

SCC or sarcoids

66

plan for dog eyelid tumor?

suspect benign adenoma tumor

REFER

cut tumor flush w eyelid - submit for histopath
incise palpebral conjunctiva perpendicular to lid margin
currette to remove tumor and debris
2 freeze and thaw cycles

67

plan for cats, cattle, horse eyelid tumors:

- resection and reconstruction

- adjunct therapy: hyperthermia, immunotherapy, laser, radiation, photodynamic therapy

- submit for histopath