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Eyelid oedema - A brief review
- 2. E Y E L I D O E D E M A Dr. ASWATHY KRISHNA. SGuided by, Dr. K. V. Subhadra Antherjanam Dr. Ashwini. B. N Dr. K. Sivabalaji
- 3. CONTENTS INTRODUCTION BRIEF ANATOMY COMMON OEDEMATOUS CONDITION OF EYELID VARTMA SHOPHA CONCLUSION REFERENCES
- 4. A movable fold of skin and muscle that can be closed over the eyeball or opened at will. Each eye has an upper and a lower lid; also known as a palpebra.
- 5. VARTMA नयनगोलकािरकं ननमेषोन्मेषाश्रयंपटलद्ियं िर्तमम उच्यते| (Ma.Ni.59/76) द्िे िर्तममपटले विद्याच्चर्तिायमन्यानन चाक्षिणण | जायते नतममरं येषु व्याध िः परमदारुणिः || (Su.U.1/17)
- 6. FUNCTIONS • 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.
- 7. APPLIED ANATOMY • Acts as shutters, protecting eyes from injuries and excessive light. • Also helps in spreading tear film over cornea and conjunctiva. • Helps in drainage of tears. • Parts – 2 Orbital Tarsal
- 8. Ciliary part Lacrimal part Punctum
- 10. GLANDS OF EYELID 2. Meibomian glands 4. Gland of Zeiss 3. Gland of Moll 1. Glands of Wolfring 1. Gland of Krause Modified sebaceous and sweat glands Accessory lacrimal glands
- 13. Eyelid swelling usually results from eyelid disorders but may result from disorders in and around the orbit or from systemic disorders that cause generalized oedema.
- 14. OEDEMATOUS CONDITIONS OF EYELID • Common, because of the looseness of tissue • 3 types Inflammatory oedema Passive oedema Solid oedema
- 15. INFLAMMATORY OEDEMA • Inflammation of lid – dermatitis, stye, chalazion, insect bites • Conjunctiva – conjunctivitis • Lacrimal sac – Dacryocystitis, lacrimal abscess • Lacrimal gland – dacryoadenitis • Eyeball – endophthalmitis, panophthalmitis • Orbit – cellulitis, abscess • PNS – maxillary sinusitis
- 17. SOLID OEDEMA OF EYELID • Chronic thickening of eyelids. • Hard on palpation.
- 18. PASSIVE OEDEMA OF LIDS Secondary oedema due to local or general causes 1. Local – head injury, angioneurotic oedema 2. General – renal failure, severe anaemia
- 19. ANGIO OEDEMA OF EYE • Swelling of the lower layer of skin and tissue just under the skin or mucous membranes. • May occur in the face, tongue, larynx, abdomen, or arms and legs.
- 20. COMMON CONDITIONS WITH EYELID SWELLING Blepharitis Stye / External Hordeolum Chalazion Internal hordeolum Dacryoadenitis Dacryocystitis
- 21. BLEPHARITIS • The inflammation of margin of eyelids and lacrimal gland. • SIGNS AND SYMPTOMS -Crusting around the eyes. -Tearing. -Burning sensation -Itching -Foreign body sensation
- 22. CHALAZION • Chronic non infective granulomatous inflammation of Meibomian Gland • Painless, firm swelling away from lid margin • Upper lid is more affected • Associated congestion in Conjunctiva • Mild heaviness of lids • Mechanical ptosis
- 23. Acute suppurative inflammation of glands of Zeiss and glands of Moll • Acute pain • Lid swelling • Mild watering from eyes STYE / EXTERNAL HORDEOLUM
- 25. INTERNAL HORDEOLUM • Suppurative inflammation of Meibomian gland. • PRIMARY – Staphylococcal infection • SECONDARY – Infected chalazion • Signs and symptoms same as Stye, but away from lid margin. • Intensity of pain is more
- 26. DACRYOADENITIS • Inflammation of the lacrimal gland . • Circumscribed mass in outer 1/3rd of upper lid. • Unilateral pain. • Redness.
- 27. DACRYOCYSTITIS • Inflammation of the lacrimal sac and duct . • Pain, redness and swelling over the medial aspect of the lower eyelid . • May be associated with watering and fever. • Mucoid or purulent discharge is seen when pressure is applied over the lacrimal sac.
- 28. Orbital cellulitis Infection of the soft tissues within the orbit, posterior to the orbital septum, due to spread from local sinus disease. Red, swollen, tender eyelid; extraocular movements limited due to pain or oedema; vision changes, diplopia; in children, fever and ill appearance. Preseptal cellulitis Infection of lid tissues around the orbit, often with local skin defect . Red, swollen, tender eyelid; full extraocular movements; no vision changes LOCAL INFECTIONS
- 29. LID OEDEMA DUE TO SUPERFICIAL SKIN PATHOLOGIES • Atopic dermatitis • Capillary hemangioma • Contact dermatitis
- 30. LID OEDEMA DUE TO MASS EFFECT FROM THE ORBIT • Autoimmune orbital mass effect • Cavernous sinus thrombosis • Endophthalmitis • Orbital neoplasm
- 31. GENERAL EVALUATION OF LID OEDEMA • Proper history taking • Torch light examination • Lid examination –eversion • Slit lamp examination • Examination of systemic causes. (Lab investigations) • CT • MRI
- 33. शोफ IN िर्तमम
- 34. OEDEMATOUS CONDITIONS IN VARTMAGATA ROGA Disease Vagbhata Susruta Treatment कु म्भीक कृ ष्णािः वपत्तेन बह्वव्योऽन्तिमर्तमम कु म्भीकबीजित ् कु म्भीकबीजप्रनतमािः लेखन लगण ग्रनन्थिः पाण्डुररुक्पाकिः कण्डूमान ् कठिनिः कफात ्| कोलमात्रिः अपाकिः कठिनिः स्थूलो ग्रनन्थिमर्तममभिोऽरुजिः | सकण्डूिः वपनच्िलिः कोलप्र माणो भेदन
- 35. पोथकी वपठटकािः श्वेत ाः सर्षपभ घनािः कफात ् शोफोपदेहरुक्कण्डू वपनच्िलाश्रुसमनन्ितािः रक्तसर्षपसन्निभ ाः वपडकाश्च रुजािर्तयिः लेखन उर्तसङ्धग रक्ता रक्तेन वपठटका अभ्यन्तरमुखी बाह्वयोर्तस ङ्गेऽ ो िर्तममनश्च या लेखन अञ्जननामम का मध्ये िा िर्तममनोऽन्ते िा कण्डूषारुग्िती नस्थरा| मुद्गमात्राऽसृजा ताम्रा दाहतोदिती ताम्रा वपड का, मृद्िी मन्दरुजा सूक्ष्मा भेदन बबस िर्तमम बठहिः शूनं यदन्तिः सूक्ष्मखाधचतम्| सस्रािमन्तरुदकं बबसाभं शूनं यद्िर्तमम बहुमभिः सूक्ष्मैनश्िद्ैिः| बबसमन्तजमल इि भेदन
- 36. श्याि िर्तमम श्यािं रुक्क्लेदशोफित ् बाह्वयतोऽन्तश्च श्यािं शूनं सिेदनम ् | दाहकण्डूपररक्लेठद नश्लष्ट िर्तमम नश्लष्टे कण्डूश्ियथुराधगणी लेख न कु कू णक मशशुरुच्रनताम्रािो िीिणािमिः मृद्गानत नेत्रमनतकण्डुमथाक्षिकू टं नासाललाटमवप तेन मशशुिः स ननर्तयम् || सूयमप्रभां न सहते स्रिनत प्रबद् ं, लेख न पक्ष्मोपरो कण्टकै ररि तीक्ष्णाग्रैघृमष्टं तैरक्षि शूयते
- 37. OTHER OEDEMATOUS CONDITIONS OF EYELID V.ABHISYANDA ऽल्पशोफता| शङ्खाक्षिभ्रूललाटस्य तोदस्फु रणभेदनम् ANYATOVATA यथां तीव्रामपैनच्िल्यरागशोफं विलोचनम् P.ABHISYANDA दाहो ूमायनं शोफिः श्यािता िर्तममनो बठहिः K,ABHISYANDA जाड्यं शोफो महान ् R.ABHISYANDA सवपत्तस्यन्दलिणम्
- 38. MANAGEMENT OF NETRA SOPHA SEKAM ASCHOTANA M PINDI
- 40. BEFORE AFTER
- 41. CONCLUSION • The differential diagnosis of eyelid oedema is extensive but knowledge of the key features of several potential causes can assist physicians in diagnosing this condition. • Systemic disorders such as myxoedema, renal diseases, and superior vena cava syndrome may manifest with peri-orbital oedema. • So particular attention must be paid to visual clues, exposures and other historical factors in the work-up of patients with eyelid oedema.
- 42. REFERENCES Parson’s diseases of eye. Textbook of ophthalmology, A. K. Khurana. Ashtanga Hridayam Susrutha Samhitha Madhava Nidanam Sarngadhara Samhitha Differential diagnosis of swollen red eyelid, Art Papier & David. J. Tuttle
Editor's Notes
- Upper lid – covers 1/6 of cornea Lower lid – just touches the limbus.
- Medial part – from puncta to medial canthus Lateral part – from lateral canthus to puncta
- 7 layers Skin Subcutaneous areolar tissue Layer of striated muscle – orbicularis & LPS [upper lid] Submuscular areolar tissue Fibrous layer Layer of non-striated muscle – muller’s Conjunctiva.
- uncommon cutaneous condition characterized by a hard, nonpitting oedema restricted to the forehead, glabella, upper eyelids, nose, and cheeks. Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often the nose, cheeks, forehead, and chin are most involved.[3]
- The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. It is mainly due to an allergic reaction to agents such as insect bites, foods, or medications.
- PATHOPHYSIOLOGY Inflammation of the base of the eyelashes and/ or distal aspects of the eyelids; inflammation of the lacrimal gland
- Word comes from Greek – Chalaza – means egg yolk. Also known as Tarsal cyst or Meibomian cyst.
- S-shaped upper eyelid.
- CT AND MRI TO rule out orbital cellulitis, cavernous sinus thrombosis etc