Eyelid position abnormalities

Question 1

Eyelid retraction causes

Answer 1

Thyroid eye disease (lid lag on downgaze)
Neurogenic
Mechanical
Miscellaneous

Question 2

Eyelid retraction neurogenic causes

Answer 2

Contralateral ptosis
Facial palsy
Aberrant CNIII regeneration
Parkinsonism
Marcus Gunn jaw winking (ipsilateral pterygoid mm)
Infantile hydrocephalus
Sympathomimetic eyedrops
Collier sign

Question 3

Eyelid retraction mechanical causes

Answer 3

Surgical overcorrection

Scarring

Question 4

Eyelid retraction miscellaneous causes

Answer 4

T21
Prominent globe
Uremia (summerskill sign)

Question 5

Pseudoptosis

Answer 5

Blepharospasm
Contralateral lid retraction
Dermatochalasis
Brow ptosis
Ipsilateral hypotropia
Apraxia

Question 6

Ptosis exclusions

Answer 6

Plexiform neurofibroma
Tumours
Chalazia

Question 7

Ptosis causes

Answer 7

Neurogenic
Myogenic
Aponeurotic
Mechanical

Question 8

Ptosis neurogenic causes

Answer 8

CNIII palsy

Horner’s syndrome

Question 9

Ptosis myogenic causes

Answer 9

Myasthenia gravis
Myotonic dystrophy
CPEO

Question 10

Ptosis mechanical causes

Answer 10

Mass

Scarring

Question 11

Ptosis aponeurotic causes

Answer 11

Levator weakness due to age

Question 12

Determine cause of ptosis

Answer 12

History (congenital vs acquired)
Pupil reaction

Differential:
CNIII palsy
Horner's
Myasthenia
CNIII pupil sparing palsy

Question 13

Botulinism effect on pupil

Answer 13

Pupil dilates

Question 14

Ptosis due to CNIII palsy

Answer 14

Check EOM (CNIV and CNVI unaffected)

Question 15

Ectropion causes

Answer 15

Ageing
CNVII palsy
Cicatricial (traumatic scarring/severe dermatitis)
Bulky eyelid tumour

Question 16

Ectropion treatment

Answer 16

Surgery
Ocular lubricants
Eyelid taping

Question 17

Entropion causes

Answer 17

Aging
Conjunctival scarring
Orbicularis oris spasms

Question 18

Entropion treatment

Answer 18

Surgery
Botulinum toxin injection
Epilation of lashes

Question 19

Blepharitis general

Answer 19

Staphylococcal
Seborrhoeic
Meibomianitis

Question 20

Blepharitis complications

Answer 20

Internal/external hordoleum
Trichiasis, poliosis, madarosis
Chalazion
Dry eye
Corneal vascularisation and scarring
Corneal infiltrates

Question 21

Blepharitis management

Answer 21

Lid hygiene
Topical AB
Systemic AB 6 - 8 weeks
Ocular lubricants

Question 22

Allergic eyelid diseases

Answer 22

Acute oedema
Atopic dermatitis
Contact dermatitis
Blepharochalasis

Question 23

Infectious eyelid diseases

Answer 23

Preseptal cellulitis
Herpes simples
HZV
Impetigo
Erysipelas
Impetigo
Necrotising fascitis

Question 24

Miscellaneous eyelid diseases

Answer 24

Fat herniation

Systemic causes

Question 25

Acute allergic oedema

Answer 25

Insect bite, urticaria, angioedema | Self-limiting

Question 26

Dermatitis

Answer 26

Contact with chemical, allergic in origin

Question 27

Preseptal cellulitis

Answer 27

Insect bite, minor trauma, URTI, ear infection, local spread | Systemic AB

Question 28

Herpes zoster

Answer 28

Oral antivirals

Question 29

Impetigo

Answer 29

Staph/strep | Topical and systemic AB

Question 30

Erysipelas

Answer 30

Staph (minor trauma) | AB

Question 31

Systemic eyelid oedema causes

Answer 31

Renal failure Cardiac failure SVC obstruction

Question 32

Eyelid lumps

Answer 32

``` Inflammatory Infective Neoplastic Trauma Retention cysts ```