This document discusses various disorders of the eyelids including inflammation of the eyelid glands like styes and chalazions. It describes the symptoms, signs, causes and treatment for external and internal styes as well as chalazions. Abnormalities in eyelash position like trichiasis are also covered. Other conditions discussed include symblepharon, ankyloblepharon, lagophthalmos and ptosis. Various eyelash anomalies and tumors of the eyelids including xanthelasma, basal cell carcinoma, squamous cell carcinoma and malignant melanoma are summarized as well.

1. Disorders of Lid

2. INFLAMMATION OF GLANDS OF
LIDS
 Hordeolum externum or stye
Suppurative inflammation of gland of Zeis.
 Hordeolum internum
Suppurative inflammation of meibomian gland
 Chalazion
Chronic inflammatory granuloma of meibomian
gland.

3.  It is an acute suppurative inflammation of lash
follicle and gland of the Zeis or moll
 Causative organism commonly involved is
Staphylococcus aureus.
 Predisposing factors.
1. Refractive error
2. Blepharitis
3. Habitual rubbing of eyelids
4. Diabetes Mellitus
STYE (EXTERNAL
HORDEOLUM)

4. C/F
 SYMPTOMS
-acute pain
-swelling of the lid
-watering
-photophobia
 SIGNS
 -stage of cellulitis-
localized
,firm,red,tender
swelling at the lid
margin with oedema
 -stage of abscess
formation-visible pus
point on lid margin wrt
affected cilia

5.  Treatment
1. Hot fomentation
2. Evacuation of pus by epilation of involved cilia
3. Antibiotic eye drops and ointment
4. Analgesics
5. Oral antibiotics
6. Treatment of underlying cause-recurrent stye

6.  It is also called a tarsal or meibomian cyst.
 It is a chronic non-infective lipogranulomatous
inflammation of the meibomian gland.
 Predisposing factors.
1. Refractive error
2. Blepharitis
3. Habitual rubbing of eyelids
4. Diabetes Mellitus
CHALAZION

8. C/F
 SYMPTOMS
-painless swelling in the
lid
-heaviness in lid
-blurred vision
-watering
 SIGNS
-nodule away from lid
margin
-reddish purple area

9.  Clinical course and complications
 Complete spontaneous resolution may occur
rarely.
 Occasionally, it may burst on the conjunctival
side, forming a fungating mass of granulation
tissue.
 Secondary infection leads to formation of
hordeolum internum.
 Calcification may occur, though very rarely.
 Malignant change into meibomian gland
carcinoma may be seen occasionally in elderly
patients.

10. Treatment
1. Conservative treatment.
2. Intralesional injection of long-acting steroid-TCA
3. Incision and curettage.
4. Diathermy.
5.Oral tetracycline

12. INTERNAL HORDEOLUM
 It is a suppurative inflammation of the meibomian
gland associated with blockage of the duct.
 It may occur as primary staphylococcal
infection of the meibomian gland or due to
secondary infection in a chalazion (infected
chalazion).

13. C/F
 SYMPTOMS
-Acute pain(more
intense-swelling being
embedded deeply in the
dense fibrous tissue)
-swelling of the lid
-watering
-photophobia
-
 SIGNS
-
localized,firm,red,tender
swelling of the lid with
oedema
-point of max
tenderness and swelling
is away from the lid
margin and usually
points on the tarsal
conjunctiva

16.  Treatment. It is similar to hordeolum
externum, except
that, when the pus is formed, it should be
drained by a vertical incision from the tarsal
conjunctiva.

17. ANOMALIES IN POSITION OF THE
LASHES AND THE LIDS
 Blepharospasm
 Trichiasis
 Entropion
 Ectropion
 Symblepharon
 Ankyloblepharon
 Blepharophimosis
 Lagophthalmos
 Ptosis

18. Trichiasis
-inward misdirection of cilia, directed backwards to
rub cornea with normal position of the lid margin
-causes- Trachoma, blepharitis, scars, chemical
burns, Steven-Johnson synd
-C/F- FB sensation,photophobia,pain,watering
Signs-misdirected cilia,reflex
blepharospasm,congestion
-complications-recurrent corneal abrasions,corneal
opacities,vascularization,non-healing corneal
ulcer
Treatment: Epilation, Electrolysis, Cryosurgery,
Argon laser application.

19. ABNORMALITIES OF THE
LASHES
 Trichiasis

20. Distichiasis
an additional row of lashes
occupies the position of meibomian glands.
abnormal growth of lashes.

21. Poliosis
 Greying of eyelashes and eyebrows. It is due to lack of melanin
(pigment) in the hair shafts of the affected area.
 Causes of Poliosis:
1. Idiopathic
2. Local conditions
• Chronic anterior blepharitis
• Sympathetic ophthalmitis
• Lid margin tumours
• Herpes zoster ophthalmicus
• Alopecia areata
 3. Systemic conditions
• Vogt-Koyanagi-Harada syndrome in which it is associated with vitiligo
• Waardenburg syndrome
• Marfan syndrome
• Tuberous sclerosis

23. SYMBLEPHARON
 This is the condition where adhesion of the lid the globe
take place.
Any cause which produces raw surfaces on two opposed
areas of the palpabral and bulbar conjunctiva will lead to
adhesion during the healing process.
 Aetiology:
1. Chemical burns { alkali ]
2. Thermal burns
3. membranous conjunctivitis
4. ocular pemphigoid.
5. steven johnson syndrome.
6. post operative.
 7.trachoma.

24. ANKYLOBLEPHARON
• It is a condition of the adhesion of the margins of
two eyelids. Adhesion may be partial or complete,
• Etiology
Congenital or acquired due to chemical burn i.e.
acid, alkali.
Treatment
 Separation of lid margins along with mucus
membrane or conjunctival grating is
recommended

25. LAGOPTHALAMOS
• It is a condition of incomplete closure of palpebral aperture when
eyes
• Lagophthalmos is defined as the inability to close the eyelids
completely. Blinking covers the eye with a thin layer of tear fluid,
• Etiology
• Loss of function of the facial nerve inhibits eyelid closure as well
as the blinking reflex.
Congenital deformity of lids, ectropion ,proposis (abnormal
protrusion or displacement of an eye, paralysis, absence of
reflex, blinking in extremely ill patient's
• Treatment
Application of antibiotic eye ointment & bandage during sleep is
recommended.
Levofloxacin

27. TUMOURS OF LIDS
 Benign growths
 Xanthelasma
 Naevus or mole
 Haemangioma
 Neurofibromatosis

28. XANTHELASMA

29.  Malignant tumours
 Basal cell carcinoma
 Squamous cell carcinoma
 Sebaceous cell carcinoma
 Malignant melanoma

30. BASAL CELL CARCINOMA

31. SQUAMOUS CELL
CARCINOMA

32. SEBACEOUS CELL
CARCINOMA

33. MALIGNANT MELANOMA

34. Thank You