Flashcards in Eyelids Deck (55):
What are the 4 layers of the eyelid?
What is the main function of the skin of the eyelid?
CN V maxillary and ophthalmic branches of ophthalmic
What muscle functions to open the eyelid?
Levator palpebrae superioris (oculomotor nerve)
Mullers muscle (sympathetic innervation)
What muscle functions to close the eyelids?
Dysfuntion of the levator palpebrae superioris causes drooping of the eyelid, which is called?
Dysfuntion of the orbicularis oculi causes incomplete closure of the eyelids, which I is called?
What is the tarsus of the eyelid?
Fibrous and glandular layer
== holding layer for surgical closure
Supports meibobmian glands
What do you call rolling of the eyelid margin so that the hairs are touching the ocular surface?
What are the two types of entropion?
Anatomic — hereditary or acquired
Blepharospasm — stimulated by ocular pain and globe retraction
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
What are acquired causes of anatomic entropion?
Blepharospasm (ocular pain causes blepharospasm —> entropion—> more irritation and pain)
How can we differentate anatomic and blepharospasm entropion ?
Take away the pain that causes the blepharospasm —- procaracaine
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
You have determined that an entropion in your patient is secondary to dehydration retaliated enophthalamos.
How would you treat this?/
Eyelids tacking (rolls out the eyelid)
Partial temporary tarsorrhaphy brings eyelid margins together
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)
What do you call an eversion or rolling out of the eyelid?
Common causes of ectropion?
Iatrogenic — overcorrection of entropion
Hereditary in hounds and giant breeds
Treatment if ectropion ?
Lateral eyelids wedge excision
V to U plasty
What are common causes of lagophthalmos?
CN V or CN VII dysfunction
Temporary treatment of lagophalmos?
Lubrication or temporary tarsorrhaphy
Permanent treatment of lagophthalmos ?
What is horners syndrome?
Loss of sympathetic innervation —> lack of tone of orbital smooth and skeletal muscle
What clinical signs are associated with horners syndrome?
Passive elevation of third eyelid
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
How can you confirm and localize horners syndrome?
Phenylephrine (diluted to 1%)
Normal eye— dilation should occur in 60 to 90minutes
—post ganglionic -> dilation in 20mins
—pre ganglionic -> dilation in 30-40mins
What are three conditions of abnormal hairs that can cause irritation to the cornea or conjunctiva
Hairs growing from normal skin and reach the cornea/conjunctival surface are called?
Treatment for trichiasis?
Conservative — lubrication
Aggressive — facial fold resection, medial canthoplasty (must preserve nasolacrimal duct)
What do you call cilia that emerge from the meibomian glands?
What breeds can have an inherited ditichia?
Treatment for distichia and ectopic cilia?
- two freeze thaw cycles
Multiple treatments required
What do you call hair/cilia protruding through the palpebral conjuntiva?
Cause pain and corneal disease (ulcers)
Canine tumors mostly demonstrate (malignant/benign) characteristics
Feline eyelids tumors mostly demonstrate (malignant/benign) characteristics
What are the most common canine eyelid tumors?
Meibomian gland adenoma
Most common tumors of feline eyelid?
Squamous cell carcinoma
Mast cell tumor
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??
What are the treatment options for eyelid tumors?
Debulk and cryotherapy
-higher chance of regrowth
-must reconstruct eyelids margin
What are the four key concepts when closing eyelid margin defects?
Closure must be perfect
Avoid full thickness suture bites
Tarsus is the holding layer
What suture pattern do you use when bringing the eyelid margin back together?
First bite from skin to defect
Defect to eyelid margin
Eyelid margin to defect
Defect back to skin
What do you call inflammation of the eyelids?
What do you call an enlargement of the meibomian gland due to blockage of its duct and inspissation of its secretory products?
How do you treat a chalazion?
Surgical incision and drainage (chalazion curette)
Tropical antibiotic with steroids
What do you call a purulent bacterial infection of the meibomian gland? What if multiple are involved?
What are signs of hordeolum, and the most common bacteria involved?
Erythema and swelling of lids
Therapy for bacterial blepharitis?
Tropical antibiotic-steroid ointment
The third eyelid is located?
Ventral and medially
There are two surfaces of the third eyelid, both lined with conjunctiva. What are they?
What provides the support for the third eyelid?
T shaped cartilage
What lives at the base of the T shaped cartilage of the third eyelid?
Gland of the third eyelid
What is cherry eye?
Prolapse of the third eyelid
What happens if you leave cherry eye untreated?
Contributes 35-45% of the aqueous tear film
T/F: excision of the glad in an appropriate treatment for cherry eye
The ONLY indication for removal is neoplasia
Treatment for cherry eye?
Morgan pocket technique
-incise over bulbar conjunctiva inferior and superior to gland and connect the incision
-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