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RUSVM SAM 2 > Eyelids > Flashcards

Flashcards in Eyelids Deck (55):
1

What are the 4 layers of the eyelid?

Skin
Muscle
Tarsus
Conjunctiva

2

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

Sensory protection

CN V maxillary and ophthalmic branches of ophthalmic

3

What muscle functions to open the eyelid?

Levator palpebrae superioris (oculomotor nerve)

Mullers muscle (sympathetic innervation)

4

What muscle functions to close the eyelids?

Orbicularis oculi

5

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

Ptosis

6

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

Lagophthalmos

7

What is the tarsus of the eyelid?

Fibrous and glandular layer

== holding layer for surgical closure

Supports meibobmian glands

8

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

Entropion

9

What are the two types of entropion?

Anatomic — hereditary or acquired

Blepharospasm — stimulated by ocular pain and globe retraction

10

What are hereditary entropion causes?

Abnormal medial canthus—brachycephalic

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

Excessive facial folds

11

What are acquired causes of anatomic entropion?

Enophthalamos

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

12

How can we differentate anatomic and blepharospasm entropion ?

Take away the pain that causes the blepharospasm —- procaracaine


13

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

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

14

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

How would you treat this?/

Temporary correction

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

15

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

temporary suture tacking — until grown into face

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

16

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

Entropion

17

Common causes of ectropion?

Iatrogenic — overcorrection of entropion

Hereditary in hounds and giant breeds

18

Treatment if ectropion ?

Lateral eyelids wedge excision

V to U plasty

19

What are common causes of lagophthalmos?

Breed variation
Exophthalmos
Buphthamos
CN V or CN VII dysfunction

20

Temporary treatment of lagophalmos?

Lubrication or temporary tarsorrhaphy

21

Permanent treatment of lagophthalmos ?

Permanent tarsorrhaphy

Canthoplasty

22

What is horners syndrome?

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

23

What clinical signs are associated with horners syndrome?

Enophthalamos
Passive elevation of third eyelid


Ptosis

Miosis

24

What is the EDx of horners syndrome

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

How can you confirm and localize horners syndrome?

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

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

Trichiasis

Disctichiasis

Ectopic cilia

27

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

Trichiasis

28

Treatment for trichiasis?

Conservative — lubrication

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

29

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

Distichia

30

What breeds can have an inherited ditichia?

Cocker spaniel
Poodles
Sheepdogs

31

Treatment for distichia and ectopic cilia?

Cryotherapy
- two freeze thaw cycles
-then pluck

Multiple treatments required

32

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

Ectopic cilia

Cause pain and corneal disease (ulcers)

33

Canine tumors mostly demonstrate (malignant/benign) characteristics

Benign

34

Feline eyelids tumors mostly demonstrate (malignant/benign) characteristics

Malignant

35

What are the most common canine eyelid tumors?

Meibomian gland adenoma

Melanocytoma

36

Most common tumors of feline eyelid?

Squamous cell carcinoma

Fibrosarcoma

Mast cell tumor

Adenocarcinoma

37

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

Irritation? - causing KCS?

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

Location — involving nasolacrimal ducts or canthus??

38

What are the treatment options for eyelid tumors?

Debulk and cryotherapy
-higher chance of regrowth

Complete excision
-must reconstruct eyelids margin

39

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

Limited debridement

Closure must be perfect

Avoid full thickness suture bites

Tarsus is the holding layer

40

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

Figure 8

First bite from skin to defect

Defect to eyelid margin

Eyelid margin to defect

Defect back to skin

41

What do you call inflammation of the eyelids?

Blepharitis

42

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

Chalazion

43

How do you treat a chalazion?

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

44

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

Hordeolum

Meibominanitis (multiple)

45

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

Erythema and swelling of lids
Pruritus
Pain
Chemosis
Conjunctivitis

Staph aureus

46

Therapy for bacterial blepharitis?

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

Tropical antibiotic-steroid ointment
Warm compress

47

The third eyelid is located?

Ventral and medially

48

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

Palpebral surface

Bulbar surface

49

What provides the support for the third eyelid?

T shaped cartilage

50

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

Gland of the third eyelid

51

What is cherry eye?

Prolapse of the third eyelid

52

What happens if you leave cherry eye untreated?

Contributes 35-45% of the aqueous tear film

Chronic conjunctivitis
KCS

53

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

False

The ONLY indication for removal is neoplasia

54

Treatment for cherry eye?

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

Possible complication to morgan pocket technique?

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