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The Eyelids Husam Salhab
 

The Eyelids Husam Salhab

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    The Eyelids Husam Salhab The Eyelids Husam Salhab Presentation Transcript

    • THE EYELIDS Husam Salhab
    • Objectives
      • Anatomy of the eyelids
      • Function of the eyelids
      • Diseases of the eyelids
      بسم الله الرحمن الرحيم
    • Modified sebaceous gland, oily secretions Ciliary glands (glands of moll) Modified sweat glands open b/n adjacent lashes
    • Function of the eyelids:
      • The eyelids provide physical protection to the eye .
      • Prevent drying of the eyes.
      • Ensuring normal tear film and drainage.
      • Secrete the oily part of the tear film.
    • Diseases of the eyelid Abnormal position Inflammation Lumps (masses) Abnormalities of the lashes
    • ABNORMAL LID POSITION Ptosis Entropion Ectropion
    • Ptosis: Abnormal low position of the upper eyelid
      • Causes:
      • 1-Mechanical factors
      • (a) large lid lesions.
      • (b) lid edema.
      • (c) tethering of the lid by conjunctival scaring.
      • (d) structural abnormalities.
      • (disinsertion of aponeurosis of the lavator muscle)
      Ptosis
      • 2-neurological factors
      • (a) 3 rd nerve palsy (oculomotor)
      • (b) horner’s syndrome
      • (c) marcus-gunn jaw-winking syndrome
      • 3-myogenic factors
      • (a) myasthenia gravis
      • (b) some forms of muscular dystrophy
      • (c) chronic external opthalmoplegia
      • (ocular myopathy).
      • Symptoms:
      • -cosmotic effect.
      • - vision impairment.
      • -symptoms associated with the
      • underlying cause (diplopia, reduced
      • eye movment).
      • signs :
      • -Reduction in size of interpalpebral opening.
      • -Abnormal function of the levator muscle.
      • -Increasing ptosis after repeated elevation and
      • depression of the lid .
      • -others(miosis, lack of sweating..).
      • Treatment :
      • -Treat the underlying cause
      • -surgical correction.
      • Entropion: It is an inturning of the lid.
      • (usually the lower lid).
      • Causes:
      • -Weakness of the orbicularis muscle
      • -Conjuctival scarring
      • Symptoms and signs :
      • -Irritation of the eye
      • -Redness
      • Treatment :
      • -Lubricants or taping of the eyelid for
      • short term treatment.
      • -Surgery for permanent treatment
      • Ectropion: an outwards turning of the lid from globe.
      • -Frequently associated with epiphora and
      • chronic conjunctivitis.
      • Causes:
      • -Orbicularis muscle laxity
      • -Scarring of the periorbital skin
      • -7 th nerve palsy (facial)
      • Treatment: surgical.
    • INFLAMMATION OF THE EYELIDS
      • Blepharitis
      • -Chronic eyelid inflammation.
      • -sometimes associated with staphylococcal infection.
      • -It causes squamos debris, inflammation
      • of the lid margin, skin and eyelash follicles.
      • - the meibomian gland may be affected.
    • Blepharitis squamos debris, inflammation of the lid margin, skin and eyelash follicles
      • Signs and symptoms :
      • -Tired eyes (worse in the morning)
      • -Crusting
      • -Scaling
      • -debris around the eyelash
      • -Reduction in number of eyelash
      • -Obstructon,plugging and cloudy secretions of meibomian ducts.
      • Treatment :
      • -Lid toileting or diluted baby shampoo.
      • (anterior blepharitis)
      • -lid massage after a hot bath to remove
      • the abnormal meibomian gland
      • secretions
      • -topical or systemic antibiotic for staph.
      • Infection.
      • -topical steroids.
      • -artificial tears.
    • DISORDERS OF THE EYELID GLANDS
      • Chalazion :
      • Common painless condition
      • Meibomian gland obstruction cause chronic granulomatous inflammation within the tarsal plate.
      • Symptoms: lid swelling,usually resolves within 6 months.
      • If not resolved :surgical incision
      • Complications: - painful abscess within the
      • meibomian gland
      • -stye.(abscess in the eyelash
      • follicle)
    • Chalazion
    • BENIGN LUMPS
      • Ductal Cysts :
      • Cyst of Moll:
      • translucent cyst on the lid margin
      • caused by sweat gland obstruction
      • Cyst of Zeis:
      • opaque cyst on the eyelid margin
      • caused by accessory sebacous gland blockage
      • Rx: excision for cosmetic reasons
      • Squamous cell papilloma:
      • frond-like lid lesion ( ورق الشجر ) with fibrovascular core and thickened squamous epithelium.
      • Usually asymptomatic but can be excised for cosmotic reasons with cautery to the base.
      • Naevus :
      • Lesions derived from naevus cells(altered melanocytes)
      • Can be pigmented or non pigmented.
      • No treatment is necessary.
    •  
      • Xanthelasma : Bilateral soft yellow lipid containing plaques
      • Associated with hypercholesterolaemia
    • MALIGNANT TUMORS
      • Basal cell carcinoma :
      • 90% of eyelid malignancies
      • Nodular ,sclerosing or ulcerative(rodent ulcer) lesions
      • Pale pearly margins
      • Painless
      • Slow growing
      • Non metastatising
      • Locally invasive
      • Rx : the earlier it is detected the easier to be removed
      • excision biopsy with a margin of healthy tissue.
      • cryotherapy
      • radiotherapy
    • Pale, Ulcerated, Nodule
      • Squamous cell carcinoma:
      • 2 nd most common
      • More malignant
      • Metastatize to regional LNs
      • Rapidly growing
      • Hard nodules or scaly patches
      • Rx: complete surgical removal.
    • Hard nodules or scaly patches
    • ABNORMALITIES OF THE LASHES
      • Trichiasis :
      • Condition in which eyelashes turn inward toward the globe.
      • Corneal irritation and abrasion .
      • Presentation : irritation and tearing.
      • Rx : pluck( قص ) eyelash ; recurrence can be treated with electrolysis .
    • THANK YOU تمّت بحمد الله