A review for medical students.

1. EYELID AND
ADNEXAL
DISORDERS
By: Qurat-ul-ain
Ophthalmic Medical
Technologist/ MBA Health
& Hospital management

2. CYSTS
Inclusion cyst
Occurs in any part of
the eyelid following
trauma or infection.
Retention cyst
These are the results of
blockade of ductal
opening of eccrine
glands
May contain clear or
sebaceous material
based on the type of
gland involved
Dermoid cyst
Encountered in midline
or fusion lines
Frequently seen in
infants and adolescents.

3. INFLAMMATION OR INFECTION

4. BLEPHARITIS
Effecting the eye-lids
Chronic inflammation of lid-margin
Types: staphylococci or seborrheic
Symptoms: foreign body sensation, burning,
mattering
Signs:
May pre-dispose to chalazia, blepharon-conjunctivitis,
loss of lashes.
Crusting in the lashes & thickened lid-margin
Treatment:
Warm compresses
Lid scrubs with 50/50 mixture of non-irritating
shampoo & water daily
Antibiotic ointment at bedtime for 2-3 weeks
(bacitracin or erythromycin).

5. HORDEOLUM
Internal Hordeolum External Hordeolum
Staph. Abscess of
meibomian gland
Staph. Abscess of lash
follicles & associated
glands of zeis and moll.
Tender swelling within
tarsal
Tender swelling at lid-
margin
May discharge via skin
or conjunctiva
May discharge via skin.
A suppurative non-specific
inflammation of eyelid adnexa.
On the basis of inflammation
site, it has two types:
Internal hordeolum
External hordeolum
Begins as diffuse swelling
followed by localization of a
nodule to the lid-margin.
Staphylococcal infection of Zeis
gland.

6. CHALAZION
Chronic non-infective
granulomatous inflammation of
sebaceous glands of lids
with/without granulomatous
reaction
Zeiss gland inflammation –
external chalazion
Meibomian gland – internal
chalazion
Etiology:
Obstruction of meibomian gland orifice
resulting in accumulation of sebaceous
secretion within acini of gland. Obstruction
caused by infection conditions.
Treatment:
Conservative treatment:
Observation expression
Hot fomentation
Medical treatment:
Topical steroid and antibiotic
Corticosteroid injection into or around the lesion
Surgical
Incision and curettage

7. ENTROPION
Treatment:
Medical treatment:
It is short term and includes use of lubricants, soft
contact lenses, tapping and orbicularis denervation
with botulinum injection or alcohol injections.
Surgical treatment:
Transverse everting sutures
Wedge resection
Weiss procedure
Jones procedure
Lateral tarsal strip procedure
A condition in which eye-lid
margin is inverted inward
towards the globe. It is a result
of involutional or due to
cicatrization.
Types:
o Congenital
o Acquired

8. ECTROPION: Treatment:
Medical treatment:
Artificial tears and lubricants at bedtime
Surgical treatment:
oMedial conjunctivoplasty
oHorizontal lid shortening
oExcision of tarso-conjunctival pentagon
A condition in which eye-lid
margin is everted away from
the eye-ball.
Types:
o Congenital
o Acquired
o Mechanical

9. OTHER
INFECTIONS/
INFLAMMATIONS
• Bacterial / mycobacterial agents may produce
non-granulomatous or granulomatous reaction
accordingly.
• Viral infections that affect skin
Molluscum
contagiosum
• Prescence of molluscum bodies
• Result of enlargement and distension of
epidermal cells with viral inclusions.

10. THANK YOU!