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VMCVM Ophthalmology > Eyelids > Flashcards

Eyelids Flashcards

(56 cards)

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1
Q

Muscles and ligaments of the eye

A
  1. Orbicularis oculi - CN7 - closes eye
  2. Levator palpebrae - CN3 - raises eyelid
  3. Müller’s Muscle - raises the upper lid, Horner’s if non-functional
  4. Retractor anguli oculi - retracts the lateral canthus temporally, entropion if malformed
  5. Medial canthal ligament - retracts medial canthus medially, medial entropion in brachycephalic breeds
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2
Q

Do cats have eyelashes?

A

No, no true eyelashes

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3
Q

Do dogs have eyelashes?

A

Yes, upper lid only

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4
Q

Do food animals and horses have eyelashes?

A

Yes both upper and lower, yet lower are usually less developed

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5
Q

What are the glands that surround the base of eyelashes/cilia?

A

glands of Zeis

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6
Q

Tarsal or Meibomian glands

A

Produce OILY secretion of tear film
approximately 40 in dogs and cats and more in large animals
Perpendicular to lid margin

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7
Q

Orbital septum/tarsal plate

A

not developed in domestic animals. is what allows humans to “flip” their lids

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8
Q

palpebral conjunctiva

A

have goblet cells that produce mucus layer of tear film

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9
Q

Dazzle response

A

afferent pathway via CN II, efferent response via CN VII and CN VI

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10
Q

Menace response

A

afferent is via CN II, efferent is via CN VII and CN VI

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11
Q

Palpebral reflex

A

afferent is via CN V (ophthalmic or maxillary branch) and efferent is via CN VII

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12
Q

Corneal reflex

A

afferent via CN V (ophthalmic branch), efferent via CN VII and CN VI

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13
Q

Where does oxygen in the pre-corneal tear film come from?

A

capillaries in the palpebral conjunctiva

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14
Q

What is eyelid agenesis?

A

a.k.a eyelid coloboma

uncommon, seen in the cat if you do. Lateral upper eyelid

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15
Q

Eyelid ageneis clinical signs:

A

mucoid to mucopurulent ocular discharge, attempts at squinting (lower lid raised), apparent pain and discomfort, third eyelid protrusion, neovascularization and pigmentation of the cornea due to exposure and probably more importantly, frictional irritation from hairs (trichiasis) rubbing on the corneal surface, and vision loss

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16
Q

Eyelid agenesis treatment:

A

No single surgery will fix the eyelid. Must treat for tear film no matter what. Cryo can fix mild cases to remove trichiasis

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17
Q

What are Eyelid and corneal dermoids?

A

most commonly seen Laterally
awkard growing epithelial tissue, like a hair spot
remove if interfere with blinking or closing eye

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18
Q

What is distichiasis?

A

Abnormal hairs that originate from the meibomian glands

Normally seen in Dogs

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19
Q

Breeds predisposed to distichiasis?

A

Poodles, Cocker Spaniels, Shih Tzus, Shelties, Huskies, Bulldogs, and Samoyeds

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20
Q

Distichiasis clinical signs:

A

asymptomatic, or the distichia can cause frictional irritation to the corneal surface with signs of blepharospasm, epiphora, and/or corneal ulcers, pigmentary keratitis, and/or corneal neovascularization

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21
Q

Treatment of distichiasis

A

Removal of hair and destruction of the damn hair follicle by CRYOtherapy.
DO NOT PLUCK, they come back worse

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22
Q

What is trichiasis?

A

Hair from the face that touches the eye. Can be from several things: entropion, long hair, medial entropion (brachy breeds), nasal folds (brachy breeds)

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23
Q

Trichiasis breeds:

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A

small, furry brachycephalic breeds

24
Q

Treatment of trichiasis:

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A

depends on the cause but good hygiene in nasal fold dogs, medial canthoplasty for medial entropion or nasal fold dogs

25
What are ectopic cilia?
aberrant distichia, seen in Younger dogs, Pugs Bulldogs and Shitzus
26
Ectopic cilia clinical signs:
PAINFUL and can cause recurrent ulceration, deteriorate and can perforate cornea
27
Ectopic cilia treatment:
excision of offending cilia and cryo
28
What is entropion?
inversion of the eyelids with secondary frictional irritation to the corneal and conjunctival surfaces seen in DOGs, mostly brachycephalic breeds occasionally in cats, horses, sheep and rarely cattle
29
Who gets lower lid entropion?
sporting breed dogs
30
Who gets upper lid entropion?
heavy browed: Bloodhounds, Sharpeis, Neapolitan mastiffs, and others
31
Who gets lateral canthal entropion?
excessive skin on the face: Chows, Sharpeis, and dogs with macropalpebral fissures such as Mastiffs, Saint Bernards, Newfoundlands, etc.
32
Who gets medial canthal entropion?
Brachycephalic breeds since medial canthal ligament is too tight
33
Who gets spastic entropion?
all dogs predisposed to entropion. The entropion causes there eyes to spaz the fuck out
34
Treatment of entropion:
First time, ointment or other medical means. can Tack back the eyelid to stop the irritation cycle Really bad --> Hotz-Celsus procedure rolls eyelid out Excessive skin dogs may require upper and lower Hotz-Celsus and lateral canthal "arrowhead" technique
35
What is ectropion?
lax eyelid allows for eversion of the eyelid, causing exposure of the conjunctiva and cornea with spillage of tear onto the facial hair/skin
36
Breeds predisposed to ectropion?
Sad-faced dogs predisposition; can be due to transient fatigue; can be from CN7 paralysis; can be due to post-op scar tissue formation
37
Treatment of ectropion:
Medical: frequent lubrication and cleaning Surgical: shorten lower lid margin, shorten palpebral fissure, or more involved blepharoplastic procedures
38
What is nasal fold keratoconjunctivitis?
seen in Brachy dogs: Pekingese, Shih Tzus, Lhasa Apsos, Cavalier King Charles Spaniels, and Pugs A too tight medial canthal ligament causes medial entropion and hairs rub the surface of the eye, irritating the shit out of it
39
Treatment of nasal fold keratoconjunctivitis:
Medial canthoplasty super blood procedure, most owners don't want removal of nasal folds
40
What is lagophthalmos?
a.k.a. euryblepharon; common in brachy breeds: Boston Terriers, Pugs, Pekingese, and others Sleep with their eyes OPEN!!! and problems ensue from there may be 2˚ to CN7 (neuroparalytic keratitis) or CN5 (neurotropic keratitis) paralysis
41
Clinical signs of lagophthalmos:
these dogs tend to sleep with their eyelids partially open. They may have chronic or intermittent conjunctivitis, the incidence of recurrent corneal ulcers in the axial portion of the cornea is great, these animals many times will have pigmentary keratitis, especially of the nasal and axial portions of the cornea, and these dogs are much more prone to developing deep, proteolytic enzyme “melting ulcers”.
42
Treatment of lagophthalmos:
Medical: lube at night
43
Major concern of eyelid laceration:
is the Globe okay? if exposed we worry about exposure keratitis --- immediate surgical repair indicated
44
Treatment of eyelid laceration:
do NOT remove eyelid; prevent self-trauma! Surgical: MULTI-LAYERED closure: Tarsal plate --> Muscular layer --> Skin last
45
What is blepharitis?
inflammation of the eyelid
46
Bacterial blepharitis
Staph -- systemic Abx -- prevent self trauma
47
Mycotic blepharitis
Microsporum canis in dogs and cats; Malassezia in dogs; T. mentag in cattle and rarely in horses -- remove underlying cause (dogs treat chronic tearing and epiphora) and clean up ear problems -- Systemic antifungals or dilute betadine
48
What are chalazia?
inflamed meibomian glands -- staph or strep -- Express the material, use moist, warm compress, topical and systemic antibiotics -- cats get lipogranulomatous blepharitis, use surgery and cryo
49
Parasitic blepharitis
Dog - Demodex Cat - Sarcoptic mange, cuterebra Horse - habronema Remove cuterebra; treat demodex with Amitraz or oral ivermectin
50
Allergic blepharitis
Neomycin and gentamicin in dogs; bee stings, vacc. reactions; atropine rarely; pollen or wood Remove inciting allergy; Steroids can be used sytemic or topical
51
Immune mediated diseases associated with mucocutaneous junctions
1. Pemphigus vulgaris 2. Systemic lupus erythematosis 3. Discoid lupus 4. “Puppy strangles” Treat by identifying the cause, systemic steroids or other immunosuppressants, plus supportive care
52
most common Eyelid neoplasias of Dog
Dog - Meibomian Adenoma, then melanomas (eyelid usually benign but conjunctival BAD like oral) and uncommonly SCC
53
most common Eyelid neoplasias of Cat
Feline - ALL CONSIDERED MALIGNANT; ocular SCC most common then fibrosarcomas and mast cell tumors; apocrine Hidrocytoma usually benign in cat
54
most common Eyelid neoplasias of Horse
SCC ocular most common then sarcoid, melanomas uncommon,
55
most common Eyelid neoplasias of Bovine
ocular SCC
56
Eyelid neoplasia treatment
Type, location and equipment available all matter. Meibomian adenomas respond well to surgical debulk and cryo Ocular SCC debulk and cryo Radio hypERthermia for SCC and sarcoid of horse Large animals intralesional chemo with BCG, cisplatin and 5-fluorouracil CO2 lasers work Radiation therapy can be used

VMCVM Ophthalmology (7 decks)

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