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RUSVM SAM 2 > Eyelids > Flashcards

Eyelids Flashcards

1
Q

What are the 4 layers of the eyelid?

A

Skin
Muscle
Tarsus
Conjunctiva

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2
Q

What is the main function of the skin of the eyelid?

A

Sensory protection

CN V maxillary and ophthalmic branches of ophthalmic

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3
Q

What muscle functions to open the eyelid?

A

Levator palpebrae superioris (oculomotor nerve)

Mullers muscle (sympathetic innervation)

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4
Q

What muscle functions to close the eyelids?

A

Orbicularis oculi

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5
Q

Dysfuntion of the levator palpebrae superioris causes drooping of the eyelid, which is called?

A

Ptosis

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6
Q

Dysfuntion of the orbicularis oculi causes incomplete closure of the eyelids, which I is called?

A

Lagophthalmos

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7
Q

What is the tarsus of the eyelid?

A

Fibrous and glandular layer

== holding layer for surgical closure

Supports meibobmian glands

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8
Q

What do you call rolling of the eyelid margin so that the hairs are touching the ocular surface?

A

Entropion

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9
Q

What are the two types of entropion?

A

Anatomic — hereditary or acquired

Blepharospasm — stimulated by ocular pain and globe retraction

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10
Q

What are hereditary entropion causes?

A

Abnormal medial canthus—brachycephalic

Abnormal palpebral fissure — often too large and loose in hounds and giant breeds

Excessive facial folds

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11
Q

What are acquired causes of anatomic entropion?

A

Enophthalamos

Blepharospasm (ocular pain causes blepharospasm —> entropion—> more irritation and pain)

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12
Q

How can we differentate anatomic and blepharospasm entropion ?

A

Take away the pain that causes the blepharospasm —- procaracaine

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13
Q

Why do we need to differentate between anatomic and blepharospastic components of entropion?

A

Failure to assess the spastic component can lead to over correction and ECTroption

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14
Q

You have determined that an entropion in your patient is secondary to dehydration retaliated enophthalamos.

How would you treat this?/

A

Temporary correction

Viscous lubrication
Eyelids tacking (rolls out the eyelid)
Partial temporary tarsorrhaphy brings eyelid margins together

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15
Q

Your patient has a congenital entropion due to excessive facial folds.. how will you treat this?

A

temporary suture tacking — until grown into face

If not fixed once growth is complete… permanent correction
— modified hotz-celsus (rolls out the eyelid)

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16
Q

What do you call an eversion or rolling out of the eyelid?

A

Entropion

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17
Q

Common causes of ectropion?

A

Iatrogenic — overcorrection of entropion

Hereditary in hounds and giant breeds

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18
Q

Treatment if ectropion ?

A

Lateral eyelids wedge excision

V to U plasty

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19
Q

What are common causes of lagophthalmos?

A

Breed variation
Exophthalmos
Buphthamos
CN V or CN VII dysfunction

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20
Q

Temporary treatment of lagophalmos?

A

Lubrication or temporary tarsorrhaphy

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21
Q

Permanent treatment of lagophthalmos ?

A

Permanent tarsorrhaphy

Canthoplasty

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22
Q

What is horners syndrome?

A

Loss of sympathetic innervation —> lack of tone of orbital smooth and skeletal muscle

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23
Q

What clinical signs are associated with horners syndrome?

A

Enophthalamos
Passive elevation of third eyelid

Ptosis

Miosis

24
Q

What is the EDx of horners syndrome

A

Idiopathic (most cases)

Injury/infarction/neoplasia of thoracic spinal cord
Avulsion of brachial plexus
Thoracic inlet or cranial mediastinal lesions
Injury or neoplasia of cervical sympathetic trunk
Otitis media
Nasopharyngeal polyps
Retrobulbar disease

25
Q

How can you confirm and localize horners syndrome?

A

Phenylephrine (diluted to 1%)

Normal eye— dilation should occur in 60 to 90minutes

Affected eye
—post ganglionic -> dilation in 20mins
—pre ganglionic -> dilation in 30-40mins

26
Q

What are three conditions of abnormal hairs that can cause irritation to the cornea or conjunctiva

A

Trichiasis

Disctichiasis

Ectopic cilia

27
Q

Hairs growing from normal skin and reach the cornea/conjunctival surface are called?

A

Trichiasis

28
Q

Treatment for trichiasis?

A

Conservative — lubrication

Aggressive — facial fold resection, medial canthoplasty (must preserve nasolacrimal duct)

29
Q

What do you call cilia that emerge from the meibomian glands?

A

Distichia

30
Q

What breeds can have an inherited ditichia?

A

Cocker spaniel
Poodles
Sheepdogs

31
Q

Treatment for distichia and ectopic cilia?

A

Cryotherapy

  • two freeze thaw cycles
  • then pluck

Multiple treatments required

32
Q

What do you call hair/cilia protruding through the palpebral conjuntiva?

A

Ectopic cilia

Cause pain and corneal disease (ulcers)

33
Q

Canine tumors mostly demonstrate (malignant/benign) characteristics

A

Benign

34
Q

Feline eyelids tumors mostly demonstrate (malignant/benign) characteristics

A

Malignant

35
Q

What are the most common canine eyelid tumors?

A

Meibomian gland adenoma

Melanocytoma

36
Q

Most common tumors of feline eyelid?

A

Squamous cell carcinoma

Fibrosarcoma

Mast cell tumor

Adenocarcinoma

37
Q

What are three common factors to consider before removing an eyelid tumor in a canine?

A

Irritation? - causing KCS?

Size? — cannot remove more than 1/3rd of eyelid margin

Location — involving nasolacrimal ducts or canthus??

38
Q

What are the treatment options for eyelid tumors?

A

Debulk and cryotherapy
-higher chance of regrowth

Complete excision
-must reconstruct eyelids margin

39
Q

What are the four key concepts when closing eyelid margin defects?

A

Limited debridement

Closure must be perfect

Avoid full thickness suture bites

Tarsus is the holding layer

40
Q

What suture pattern do you use when bringing the eyelid margin back together?

A

Figure 8

First bite from skin to defect

Defect to eyelid margin

Eyelid margin to defect

Defect back to skin

41
Q

What do you call inflammation of the eyelids?

A

Blepharitis

42
Q

What do you call an enlargement of the meibomian gland due to blockage of its duct and inspissation of its secretory products?

A

Chalazion

43
Q

How do you treat a chalazion?

A

Warm compresses
Surgical incision and drainage (chalazion curette)
Tropical antibiotic with steroids

44
Q

What do you call a purulent bacterial infection of the meibomian gland? What if multiple are involved?

A

Hordeolum

Meibominanitis (multiple)

45
Q

What are signs of hordeolum, and the most common bacteria involved?

A 
Erythema and swelling of lids
Pruritus 
Pain 
Chemosis 
Conjunctivitis

Staph aureus

46
Q

Therapy for bacterial blepharitis?

A 
Initially 
Systemic antibiotics 
-amoxicillin-clavulanic acid 
-doxycycline 
-cephalosporin

Tropical antibiotic-steroid ointment
Warm compress

47
Q

The third eyelid is located?

A

Ventral and medially

48
Q

There are two surfaces of the third eyelid, both lined with conjunctiva. What are they?

A

Palpebral surface

Bulbar surface

49
Q

What provides the support for the third eyelid?

A

T shaped cartilage

50
Q

What lives at the base of the T shaped cartilage of the third eyelid?

A

Gland of the third eyelid

51
Q

What is cherry eye?

A

Prolapse of the third eyelid

52
Q

What happens if you leave cherry eye untreated?

A

Contributes 35-45% of the aqueous tear film

Chronic conjunctivitis
KCS

53
Q

T/F: excision of the glad in an appropriate treatment for cherry eye

A

False

The ONLY indication for removal is neoplasia

54
Q

Treatment for cherry eye?

A

Morgan pocket technique
-incise over bulbar conjunctiva inferior and superior to gland and connect the incision

Orbital tacking

  • third eyelid is elevated, cut made through orbital rim and conjuntiva
  • suture passed through incision to engage periosteum, then through the palpebral surface to engage gland
  • anchors eyelid in more ventral position
55
Q

Possible complication to morgan pocket technique?

A

If tears are not allowed to drain at either end of incision, cyst may form

RUSVM SAM 2 (44 decks)

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