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Pathology of eye lids and adnexa

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Pathology of eye lids and adnexa

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Pathology of eye lids and adnexa

  1. 1. OPTOM FASLU MUHAMMED PATHOLOGY OF EYE LIDS AND ADNEXA
  2. 2. LESIONS OF EYE LIDS AND ADNEXA ARE OF FOLLOWING TYPES  1.Cysts  2.Inflamation /infections  3.Metabolic changes and degenaration  3.Tumorous conditions  4.Tumours
  3. 3. CYSTS  A cyst is a closed sac-like structure that is not a normal part of the tissue where it is found  Cysts are common and can occur anywhere in the body in people of any age.  The causes of a cyst 1. wear and tear" or simple obstructions to the flow of fluid, 2. Infections, 3. Tumors, 4. chronic inflammatory conditions, 5. genetic (inherited) conditions, and 6. defects in developing organs in the embryo
  4. 4. CYSTS  1.Inclusion cysts  2.retention cysts  3.develpmental/Dermoid cysts
  5. 5. INCLUSION CYSTS  Inclusion cysts occur in any part of eyelid following trauma or infection
  6. 6. RETENTION CYSTS  Retention cysts are the result of blockade of ductal opening of eccrine glands rarely the piloseceous apparatus may show blockade at epidermal opening .  The cysts may contain clear or sebaceous material based on the type gland involved .the so called sebaceous cyst.
  7. 7. DERMOID CYSTS  These cysts are encounterd in midline or fusion lines .Dermoid cysts are frequently seen in infants or adolescents .
  8. 8. INFLAMMATION / INFECTIONS  1.blebharitis  2.hordeolum  3.chalazion  Other infections/inflammations  1.Bacterial or myobacterial  2.Viral infections
  9. 9. BLEPHARITIS  In this type of infection ,inflammation effecting the eyelids  Chronic inflammation of the lid margin  Types: staphylococcal or seborrheic  Symptoms: foreign-body sensation, burning, mattering  May predispose to chalazia, blepharoconjunctivitis, loss of lashes
  10. 10. BLEPHARITIS TREATMENT  Warm compresses  Lid scrubs with 50/50 mixture of nonirritating shampoo (Johnson and Johnson’s baby shampoo) and water daily  Antibiotic ointment at bedtime for 2-3 weeks (Bacitracin or erythromycin)  Resistant cases can be referred to the ophthalmologist on a non-urgent basis
  11. 11. BLEPHARITIS: NOTE THE CRUSTING IN THE LASHES AND THE THICKENED LID MARGIN
  12. 12. HORDEOLUM  Hordeolum is a suppurative nonspecific inflammation of eye lid adnexa  On the basis of anatomical site of inflammation’ two forms are recognised  1. Hordeolum externum  2. Hordeolum internum
  13. 13. HORDEOLUM  Usually begins as diffuse swelling followed by localization of a nodule to the lid margin  Hordeolum – staphylococcal infection of the glands of Zeis
  14. 14. INTERNAL HORDEOLUM EXTERNAL HORDEOLUM (STYE •Staph. abscess of meibomian glands Tender swelling within tarsal •May discharge through skin or conjunctiva • Staph. abscess of lash follicle and associated gland of Zeis or Moll •Tender swelling at lid margin •May discharge through skin
  15. 15. PATHOPHYSIOLOGY  There is usually underlying meibomitis with thickening and stasis of gland secretions with resultant inspissation of the Zeis or meibomian gland orifices.  Stasis of the secretions leads to secondary infection, usually by Staphylococcus aureus. Histologically, hordeola represent focal collections of polymorphonuclear leukocytes and necrotic debris (ie, an abscess).  Essentially, a hordeolum represents an acute focal infectious process, while a chalazion represents a chronic, noninfectious granulomatous reaction. However, chalazia often evolve from internal hordeola
  16. 16. CHALAZION  Chronic non specific inflammation of sebaceous gland of lid with or with out granulomatous reaction is called chalazion  The zies gland inflammation is termed as external chalazion  The meibomian gland inflammation is termed as internal chalazion
  17. 17. THE NODULE ON THE PATIENT’S RIGHT UPPER LID IS A CHALAZION
  18. 18. PATHOPHYSIOLOGY  A chalazion forms when the meibomian gland becomes blocked and sebaceous secretions accumulate. Reaction to the material results in granulation tissue and chronic inflammation.  The large meibomian glands are embedded in the tarsal plate of the eyelid; therefore, edema usually is contained on the conjunctival portion of the lid.  Occasionally, the chalazion enlarges and breaks through the tarsal plate to the external portion of the eyelid. Blockage of the Zeis glands may cause chalazia to occur along the lid margin.
  19. 19. OTHER INFECTION AND INFLAMMATIONS  Bacterial infections  Viral infections
  20. 20. MOLL SCUM CONTAGIOSUM  MC is a multiple nodular or papular lesion with umbilicated centre .  The enlargement and distension of of epidermal cells with viral inclusions
  21. 21. VERUCOUS LESIONS  These are due to papilloma group of viruses  The lesions are characterized by exophytic proliferative warty lesions and may be multiple
  22. 22. END OF PART ONE THANKS

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