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Lids and Adnexa Class1: The eyelid margin
 

Lids and Adnexa Class1: The eyelid margin

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www.ophthalclass.blogspot.com has the complete class and MCQs on lids and adnexa for undergraduate medical students. Class 1 in the series deals with the basic anatomy of the eyelid and the eyelid ...

www.ophthalclass.blogspot.com has the complete class and MCQs on lids and adnexa for undergraduate medical students. Class 1 in the series deals with the basic anatomy of the eyelid and the eyelid margin. A few of the congenital eyelid disorders are mentioned. Special emphasis is given to blepharitis – inflammation of the eyelid margin, its types, clinical features and management. Next, common causes of eyelid swellings including hordeolum or stye and chalazion are discussed. Finally a brief mention is made about disorders of the eyelashes – trichiasis, poliosis, madarosis and distichiasis.

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    Lids and Adnexa Class1: The eyelid margin Lids and Adnexa Class1: The eyelid margin Presentation Transcript

    • THE EYELIDS and the eyelid margin
      Dr. Anupama Karanth
      www.ophthalclass.blogspot.com
    • Anatomy
      What does it have?
    • Anatomy
      In simpler terms
      Anterior lamella
      skin and orbicularis
      Posterior lamella
      tarsus and conjunctiva
    • Development
      The story begins very early…
      Two folds of ectoderm and mesoderm appear at 8 weeks
    • Development
      …and fuse by the tenth week
    • Development
      They separate again in the
      seventh month
    • Congenital anomalies
    • Congenital anomalies
      Blepharophimosis syndrome
      Ptosis
      Epicanthusinversus
      Horizontally shortened palpebral aperture
    • Congenital anomalies
    • The eyelid margin
      Posterior edge
      sharp
      mucocutaneous junction
      Meibomian orifices
      Gray line ( muscle of Riolan)
      Lash line
      Anterior edge
    • Eyelid inflammation
    • Eyelid inflammation
    • Anterior blepharitis
    • Clinical features of anterior blepharitis
    • Ulcerative blepharitis
    • Squamousblepharitis
    • Management of anterior blepharitis
      Lid hygiene
      Warm compresses
      Mechanical removal of crusts and scales by scrubbing
      Baby shampoo as scrubbing solution
      Application of antibiotic eye ointment (Staphylococcal)
      Anti-dandruff shampoo for scalp (Squamous)
    • Posterior blepharitisMeibomian gland disease/meibomianitis
      Symptoms
      Nonspecific, burning, itching, redness
      Associated condition
      Acne rosacea
      Complications
      Secondary dry eyes
      Epithelial keratitis
      Recurrent styes / chalazia
      Papillary conjunctivitis
    • Clinical features of posterior blepharitis
      Meibomian orifices
      Pouting, obstructed, oily globules
      Telangiectasia around orifices
      Digital pressure on lid margin
      Hyposecretion
      Hypersecretion – foamy, turbid or tooth paste like secretion
    • Meibomian gland disease
      Foamy secretion
      Blocked meibomian orifices
    • Management of posterior blepharitis
      Warm compresses
      Lid massage to express oily secretion
      Short term antibiotic – steroid eye ointment, ocular lubricants
      In severe cases and in acne rosacea – oral tetracycline / doxycycline for at least 6-8 weeks
    • Eyelid gland inflammations
      Acute inflammation (stye)
      Staphylococcal infection
      Glands of Zeiss / Moll (associated with hair follicles) – Hordeolumexternum
      Meibomian glands – Hordeoluminternum
      Acute, painful and tender nodular swellings of the lid
    • Hordeolum
      Hordeoluminternum
      Hordeolumexternum
    • Acute infection (Staphylococcal abscess)
      Internal hordeolumExternal hordeolum
      Meibomian gland
      Tarsal plate
      Zeis or Moll glands
      Lid margin
    • Multiple styes
    • Hordeolum
      Management of hordeolum
      Mainstay of therapy – hot compreses
      If pus pointing present at eyelash base – remove eyelash
      If pus pointing at the skin or conjunctiva – drain pus
      If associated with blepharitis – treat blepharitis
    • Hordeoluminternum
      Pointing on the skin
    • Internal hordeolum
      Pointing on the conjunctival side
    • Eyelid gland inflammations
      Chronic inflammation of meibomian gland – Chalazion
      Meibomian cyst
      Chronic
      Sterile
      Granulomatous inflammation
      Blocked meibomian gland orifice
      Painless, non-tender nodular swelling of the eyelid
    • Chalazion
      Chalazion breaking through the conjunctiva
      1A
      1B
    • Recurrent chalazia
    • Management of chalazion
    • Incision and curettage
    • Local anesthesia
    • Chalazion clamp
    • Incision
    • Curettage
    • Clamp removed
    • The eyelid infections
      Molluscumcontagiosum
    • The eyelid infections
      Herpes zoster ophthalmicus
    • Eyelash disorders
      Trichiasis
      Inturned eyelash
      Poliosis
      White colored lashes
      Madarosis
      Loss of lashes
      Distichiasis
      Lashes from meibomian orifices
    • Trichiasis
    • Poliosis
    • Distichiasis