The Eyelids

Question 1

What is the function of the eyelids?

Answer 1

To distribute tears and protection

Question 2

What % is the upper eyelid responsible for in blinking?

Answer 2

75%

Question 3

In embryology where do the eyelids come from?

Answer 3

Surface ectoderm

Question 4

Which nerve innervates blinking?

Answer 4

CN VII

Question 5

What glands are on the eyelid margin (3) and what do they do?

Answer 5

Anterior border;
Zeis- sebaceous glands
Moll- sweat glands

Eyelid Margin (grey line);
Meibomian glands - lipid portion of tears

Question 6

Where is the mucous part of the tear film produced?

By what?

Answer 6

Palpebral conjunctiva

Goblet cells

Question 7

What gland does the third eyelid have?

What does it produce

Answer 7

Acinar gland

1/3 aqueous tear production

Question 8

Where do dogs and cats have cilia? Upper or lower or both eyelids?

Answer 8

Only upper

Dogs 2 rows, cats 1 row

Question 9

What is the treatment for premature eyelid opening?

Answer 9

Topical lubricants

Question 10

What is ophthalmia neonatorum?
What is the risk of leaving this?
What can be the cause in dogs and cats?
What is the treatment?

Answer 10

Infection or the conjunctival sac prior to lid opening

Ulceration

Herpes virus

Opening eyelids with blunt ended scissors
Flushing
Topical ABs, lubricants

Question 11

What is ankylobleparon?

Answer 11

Failure for eyelids to open normally by 10-14d post natally

Question 12

Where is eyelid agenesis (coloboma) normally placed?

Answer 12

Dorsolateral position

Question 13

What breeds is distichia common?

Where are the hairs coming from?

Answer 13

Miniature long haired dachshund
English & American cocker spaniels

Meibomian glands

Question 14

Which are the common breeds for ectopic cilia?

Answer 14

Flat coated retrievers
Poodles
Pugs

Question 15

Which breeds are common for entropion?

Answer 15

Shar Pei
Bulldog
Rottweiler

Question 16

What is lateral epiphora almost pathognomonic for?

Answer 16

Lateral canthal entropion

Question 17

What is the treatment for senile entropion?

Which breed is this common in?

Answer 17

Stades procedure

English cocker spaniel

Question 18

What is the treatment for ectropion?

Answer 18

Wedge resection

Question 19

What is a hordeolum?

What is the treatment?

Answer 19

Infection of one of the eyelid marginal glands (zeis/ moll/ meibomian)

Warm compress
Lanced/ curetted
Systemic and topical ABs for 2-4w (doxy good)

Question 20

What is a chalazion?

What is the treatment?

Answer 20

Rupture of meibomian gland

Curettage and maxitrol

Question 21

What is the treatment for juvenile blepharitis (puppy strangles)?

What is the cause?

Answer 21

Systemic ABs and corticosteroids

Marked inflammatory reaction due to staphylococcal toxins

Question 22

What are the causes of blepharitis?

Answer 22

Bacterial - staph/strep
Leishmania
Demodex/ sarcoptes
Fungal (dermatophyte, ringworm)
Immune mediated (pemphigus, UVD, atopy)

Question 23

What muscle pulls the upper eyelid up?

Answer 23

Levator palpebrae superioris

Question 24

With prolapsed nictitans gland what is the % of recurrence after the

• first surgery?
• second surgery?

Answer 24

First; 5-20%

Second; 50%

Question 25

Give some differentials of third eyelid protrusion.

Answer 25

``` Enophthalmos Retrobulbar (extraconal) mass Horner’s syndrome Dysautonomia Cannabis intoxication Tetanus Rabies Toravirus in cats ```

Question 26

What is plasmoma? What are the clinical signs? Treatment? What dogs are commonly affected?

Answer 26

Plasma cell infiltration of the third eyelid conjunctiva, immune mediated Bilateral thickening TEL with nodules on the TEL margin (pink/ tan)- looks like depigmentation 0.2% Ciclosporin ointment (+/- corticosteroid drops initially) GSD, collies, Belgian Shepherd

Question 27

Which breed is predisposed to nodular granulomatous episclerokeratitis?

Answer 27

Collies

Question 28

What are the treatment options for nodular granulomatous episclerokeratitis?

Answer 28

Topical corticosteroids (May be needed long term at a maintenance dose) Systemic azothioprine/ ciclosporin Excision + cryotherapy/ beta-irradiation (strontium 90)

Question 29

In embryology where does the striated muscles of the eyelids come from?

Answer 29

Mesoderm

Question 30

In embryology where does the tarsal plate come from?

Answer 30

Neural crest mesenchyme

Question 31

Which nerve innervates the orbicularis oculi? Levator palebrae superioris? Mullers muscles?

Answer 31

VII III Sympathetic nerves

Question 32

The trigeminal nerve V ophthalmic branch is sensory to which part of the eyelid? Maxillary branch?

Answer 32

Ophthalmic branch- upper and medial | Maxillary branch- lower and lateral

Question 33

Which is; ``` Gland of third eyelid? Gland of Zeiss Gland of moll Meibomian gland Goblet cells ```

Answer 33

Question 34

What nerve issues can cause drooping of upper eyelid?

Answer 34

Denervation of the Levator palpebrae superioris (CN III) | Horners syndrome - Denervation of Muller’s myself of eyelids (sympathetic)

Question 35

are melanomas aggressive in the eyelid? In the conjunctiva?

Answer 35

Not aggressive in the eyelid, are aggressive in the conjunctiva!