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Ophtha > Eyelids > Flashcards

Eyelids Flashcards

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1
Q

Parts of eyelid and position of eyelids

A

Orbital and tarsal parts

UL covers 1/6th of cornea and LL touches the limbus

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2
Q

Lid margin is divided how?

A

Puntum divides lid margin into medial(devoid of lashes nd glands)
lateral(contains lashes and glands)

Grey line divides intermarginal strip into Ant - skin,subcut t,muscles
Post - tarsal plate,Palpebral conj

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3
Q

Striated muscles of eye lid and functions?

A

1.Orbicularis oculi - orbital,preseptal,pretarsal(Hornerks muscle nd
Muscle of rion)
(Closure of eyelids)

2.LPS only in upper eyelid(elevation of UL)

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4
Q

What is the non striated muscle in eyelid?

A

Muller’s muscle(elevation of UL)

UL - from LPS
LL - from IR

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5
Q

Nerve supply of muscles of eyelid and associated conditions?

A
  1. Orbicularis oculi-zygomatic branch of facial(7th)-Lagophthalmos
  2. LPS-oculomotor nerve-Ptosis
  3. Muller’s muscle-sympathetic - Ptosis/Horner’s syndrome
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6
Q

Glands of eyelid?

A
  1. MG/tarsal gland - seb - lipid layer of tear film
  2. Zeis - “ “
  3. Moll - sweat
    * krause @ fornices and wolfring @ up border of tarsal plate
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7
Q

Anaesthesia of eyelid given @?

Arterial supply?

A

Submucous Areolar tissue layer

Marginal arterial arcade

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8
Q

Failure of development of eyelids?

A

Crypt-ophthalmos

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9
Q

MCC of bacterial Blepharitis ?

Other names?

Complications?

Treatment?

A

Staphylococcus aureus

Chronic anterior B (or) Ulcerative B

Lash abnormalities,Tylosis,Epiphora,Dry eye,Recurrent styles

  1. Lid hygiene with hot compresses and removal of crusts
  2. Local Abs
  3. Oral abs in unresp nd complicated cases
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10
Q

Cause of Seborrhoeic/squamous blepharitis?

A

Corynebacterium acne

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11
Q

Acute inflammation of Zeis gland?

Acute inflammation of MG?

Chronic inflammation of MG?

A

Hardeolum externum (or) style

Hardeolum internum

Chalazion…..(CML)***

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12
Q

Painful swelling @ lid margin?

Painless swelling away from lid margin?

A

Style

Chalazion

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13
Q

Signs of style?

A

Stage of cellulitis - red,tender,firm swelling

Stage of abscess formation - pus point

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14
Q

Causes of recurrent hardeola?

A
  1. Childrnen -refractory error
  2. Adults - Diabetes
  3. Elderly - Sebaceous gland Carcinoma
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15
Q

Symptoms of chalazion?

Signs of chalazion?

A
  1. Painless swelling
  2. Heaviness of the lid
  3. Epiphora d/t pun time eversion
  4. Decreased vision d/t astigmatism
  5. Hard,non-tender nodule,away from the margin
  6. Reddish-purple area on lid eversion
  7. Projection on skin
  8. Marginal in some
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16
Q

Different treatments of chalazion?

A
  1. Conservative t/t for small
  2. Intralesional TRIAMCINALONE - 50%cases cure
  3. I & Curretage……2%xylocaine,chalazion scoop….vert I on conj
  4. Diathermy in Marginal chalazion
  5. Tetracycline as prophylaxis in recurrent cases
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17
Q

Difference between trichiasis and pseudotrichiasis?

A

Inward turning of lashes without eyelid - Trichiasis

- Pseudotrichiasis

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18
Q

Absence of development of eyelids?

Extra row of eye lashes and causes?

A

Cryptophthalmos

Distichiasis-cong/acq(SJS,OCP,late cicat stage of chemical injury)

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19
Q

Causes of Madarosis?

Causes of Trichomegaly?

Causes of Poliosis?

A
  1. M - Blepharitis,CryoSx (or) hypothyroidism,leprosy
  2. T - PG analogues,Cyclosporin
  3. P - VKH,vitiligo,marfan’s …ant blepharitis
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20
Q

Causes of trichiasis?

Signs of trichiasis?

Study These Flashcards
A
  1. Cicatricial trachoma
  2. Operative eyelid scar
  3. Ulcerative Blepharitis
  4. Styles
  5. Mech/thermal injuries

1.Can see the cause
2.Misdirected cilia
3.Reflex blepharospasm
&
Photophobia ……….if cornea abraded

21
Q

Treatment for trichiasis?

Study These Flashcards
A
  1. Epilation
  2. Electrolysis….2mA for 10 sec
  3. Cryosurgery….cryoprobe(-20^c for 25 sec)
  4. Surgical correction if multiple misdirected cilia
22
Q

Symptoms and signs of Entropion?

Study These Flashcards
A

Symptoms - FBS,irritation,Lacrimation,PP

Signs
1.Inturning

  1. Causative factor seen
  2. Complications seen(CU,CO)
23
Q

Symptoms and signs of Ectropion?

Study These Flashcards
A

Symptoms - Epiphora and irritation,PP

Signs

  1. Outrolling
  2. Causative factor seen
  3. Cx - Exposure K, Eczema d/t Epiphora
    * *In Involutional - laxity of horizontal lid/ Medial(or) lateral cantonal tendon
24
Q

Management of congenital entropion?

Study These Flashcards
A

Spont recovery
(Or)
HOTZ procedure

25
Management of cicatricial entropion?
1. Anterior lamellar resection 2. Tarsal wedge resection 3. Tarsal Fracture (or) Transposition of Tarso-conjunctival wedge 4. Posterior lamellar graft
26
Management of cicatricial ectropion?
1. V shaped incision with Y shaped suturing operation 2. Z-Plasty (or) Elshnig operation 3. Excision and full thickness grafting - in severe cases
27
Specific feature Etiology and Management of Involutional/Senile entropion?
* Only in Lower Lid * Horiz/vertical laxity,Over-riding of pretarsal by preseptal Management 1. Transverse (or) Everting sutures 2. Weis operation-Horiz split+everting sutures 3. Jones operation- severe cases 4. Quickert procedure - weis + Horizontal lid shortening
28
Management of involutional ectropion?
1. Medial conjunctivoplasty 2. Horizontal lid shortening with pentagonal incision 3. Bryon smith’s Kuhnt-Szymanowski operation
29
Causes and management of paralytic ectropion?
7th nerve palsy d/t bellks/head inj/ME infection Spont in 6 months (Or) 1.Temporary-Top lubricants,Taping,Suture tarsoraphy 2.Permanent - Horizontal lid tightening Palpebral sling operation
30
What is symblepharon? What is ankyloblepharon?
Adhesion btw lids and eyeball * restricted movements=>Diplopia and Lagophthalmos * t/t - Mobilising conjunctiva (or) Grafting in severe cases Adhesions btw eyelids
31
What is lagophthalmos? Causes? Cx? T/t?
Inability to close eyelids VOLUNTARILY Etiology 1. Oo paralysis 2. Symblepharon 3. Ectropion 4. Physiological Exposure keratitis and conjunctival xerosis Tear drops,soft contacts,Tarsorrhaphy
32
What is Blepharospasm? Types? Clinical features? Treatment?
Involuntary,forceful,sustained closure of eye lids 1. Essential-idiopathic(spontaneous).....botox(or)facial denervation 2. Reflex - t/t disease 1.Persistent Epiphora 2.Oedema of lids 3.Spastic entropion in elderly 4.Blepharophimosis Spastic ectropion in young
33
What is blepharophimosis? Signs seen in blepharophimosis?
Decrease in height and width of Palpebral fissure 1. Epicanthus in versus 2. Telecanthus 3. Lateral ectropion
34
What is blepharophimosis syndrome? Treatment?
``` Blepharophimosis + Mild ptosis + Epicanthus inversus + Telecanthus ``` T/t = Canthoplasty
35
What is Horner’s syndrome?
1. Mild Ptosis (muller px) 2. Miosis (sphincter pupillae px) 3. I/L decreased sweating (Anhydrosis) 4. Other - enophtalmos,heterochromia
36
Features of congenital Ptosis? Other associations?
1. Drooping of eyelid 2. Absence of lid crease 3. Lid lag on down gaze 4. LPS function - fair/poor 1. Simple 2. With superior rectus weakness 3. Blepharophimosis syndrome 4. Congenital Synkinetic Ptosis
37
Cause of congenital synkinetic ptosis?
It is d/t Trigemino-oculomotor synkinesis It is also known as Marcus Gunn jaw winking Ptosis.
38
Acquired causes of ptosis? And their treatment?
1. Neurogenic - 3rd N palsy, Horner’s syndrome - conservative t/t for 6 months at least 2. Myogenic - MG,Myotonic dystrophy 3. Aponeurotic - Involutional/Senile and postop and traumatic dehiscence 4. Mechanical - d/t weight of tumours or chalazia
39
How to treat Neurogenic cases of Ptosis?
6 months of conservative treatment should be done and then surgery * 3rd Nerve palsy = Frontalis sling operation * Horner’s syndrome = Fasanella servat operation
40
What is pseudo Ptosis? Examples?
I/L = Micro,nano,enophthalmos C/L = Retraction,High myopia,Exophthalmos,Proptosis
41
Degree of ptosis?
2mm - mild 3mm - moderate 4mm - severe
42
How to assess LPS function and what is the method used?
BURKE’s method Pt look down-> finger on eyebrow->look up ``` 15mm = normal 8mm = good 5-7mm = fair =4mm = poor ```
43
Ix done for ptosis in MG? Ix done for ptosis in Horner’s syndrome?
Edrphonium test Phenylephrine test
44
Treatment procedures for congenital ptosis?
1. Fasanella-servat operation(Tarso-conjunctivo-mullerectomy) - done in mild Ptosis with good lev function 2.Levator resection =Blaskowic’s(conj) and Everbusch(skin) - in moderate with good/fair/poor func & in severe Ptosis with fair lev func *C/I in severe with poor 3.Frontalis sling operation/Brow suspension - severe cases with no lev func
45
Slings used in Frontalis sling operation?
1. Fascia Lata 2. Supramide suture 3. Silicon rod
46
Treatment for Marcus gun jaw winking Ptosis?
Levator resection + Frontalis sling operation
47
Treatment for blepharophimosis syndrome?
``` Frontalis sling operation + Telecanthus correction + Lateral cantholysis ```
48
Ptosis in CPEO? What is the syndrome associated?
Chronic progressive external ophthalmoplegia Bilateral ptosis with all EOMs affected in all gazes ***If associated with Retinitis pigmentosa =>Kearn Sayre syndrome
49
What is cogon lid twitch sign?
Overshoot of eye when looked from down gaze to primary gaze

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