Lashes Flashcards
What is Poliosis?
Reduced or absent pigmentation of hair in any area of the body due to reduced presence or absence of melanin and/or hair follicle melanocytes
What is Trichiasis?
Misdirection of the lashes
What is Primary Trichiasis?
Misdirected lashes caused by misdirection of the hair shaft
What is Secondary Trichiasis?
Misdirected lashes due to entropian, hair shaft has normal orientation
What is Distichiasis?
An abnormal row of lashes near or in meibomian glands (rare)
What is Hypotrichosis?
Reduced hair density in any area of the body
What is Milphosis?
Lash loss
What is Hypertrichosis?
Increased hair density in any area of the body, more than normal variation for age, sex and race
What is madarosis?
Lash and/or eyebrow loss
What is Trichomegaly?
Increased lash and/or eyebrow length (>12mm), curl, stiffness, pigmentation and thickness
What are the possible aetiologies of trichiasis?
Congenital - failure of epithelial germ cells to differentiate to Meibomian glands (AD inheritance)
Acquired - entropian, severe chemical burn, eyelid laceration, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, chronic blepharoconjunctivitis, trachomatous trichiasis (multiple chlamydia infections)
What are the predisposing factors for trichiasis?
Staphylococcal bleph
Trachoma (chlamydia)
Cicatricial conditions (scarring)
What are the symptoms of trichiasis?
Ocular discomfort
Irritation
FB sensation
Watery eye
Red eye
Photophobia
One or both eyes
What are the signs of trichiasis?
Lash(es) in contact with ocular surface
Conj injection (red)
Epiphora
Corneal or conj epithelial abrasion (stains with NaFl)
What are the possible complications of trichiasis?
Pannus
Corneal ulcer and scarring
What are the non-pharm management options for trichiasis?
Epilation (will need to be done every 4-6 weeks)
Lid taping if due to entropian (temporary)
Therapeutic CL (temporary)
Lid hygiene if bleph assoc
What are the pharm management options for trichiasis?
Ocular lubricants (drops day, ointment night) - sx relief
Severe cases: initial management and urgent referral for surgery
What is Phthiriasis?
Infestation of lid margins by crab louse
What are the predisposing factors for Phthiriasis?
Sexual contact with louse infested person
Poor hygiene/close contact within infested household
What are the symptoms of Phthiriasis?
Intense lid margin itching
Red, watery eye
Uni or bilateral
What are the signs of Phthiriasis?
Madarosis
Blepharoconjunctival hyperaemia and oedema
Superficial punctate keratopathy
Petechial macules (red inflamed areas of lid margins from bites)
Poss pre-auricular lymphadenopathy (swollen lymph nodes)
Adult lice (1-1.5mm long) attached to lash (40x mag needed to see as completely transparent)
Eggs near lash base (0.5mm long, grey/white cigar shaped, shells stay in place after hatched)
Red-brown deposits at base of lashes (louse faeces and host blood)
What are the differential diagnosis for Phthiriasis?
Anterior bleph
Demodex
Allergic/infective conjunctivitis
Eczema affecting lid skin
What are the non-pharm management options for Phthiriasis?
Sensitive counselling as STD
Advice on personal hygiene
Remove lice, nits and shells at SL (forceps needed)
Advise on sxs of pubic infestation
Pharmacies can provide effective tx without rx
Advise partners/family members should have eyes examined
Wash bed linen, towels and clothes at 60 degrees for at least 5 mins
What are the pharm management options for Phthiriasis?
Apply unmedicated paraffin-based ointment 2x per day for 2 weeks to lid margins - will suffocate lice
Permethrin 1% lotion applied to lashes for 10 mins (eyes closed, rinse with cotton bud to remove - only if experienced as toxic to ocular surface)
Refer to GP for STD screening, tracing and screening close contacts and tx for non ocular elements
