OM VERMA ASSOCIATE PROFESSOR GRACIOUS COLLEGE OF NURSING ABHANPUR RAIPUR C.G

1. GRACIOUS COLLEGE OF NURSING
EYELID INFECTIONS, TUMORS AND
DEFORMITIES
PRESENTED BY
OM VERMA
Assistant professor

3. EYELID INFECTIONS, TUMORS
AND DEFORMITIES

4. Definition
1. An eyelid infection is any abnormal condition
that effect eyelids.
According to levis
According to levis
2. Infection of an oil gland on the surface of the
upper and lower parts of eyelids .
According to Brunner & Suddarth's

5. 3. A bacterial infection of an oil gland,
hair follicle or sweat gland are
caused drooping , twitching ,
inflammation , itching, burning,
crustiness, redness , edema , tearing,
crustiness, redness , edema , tearing,
irritation .
According to lippencott

6. CLASSIFICATION OF EYELIDS
CLASSIFICATION OF EYELIDS
INFECTIONS

7. A. CONGENITAL ANOMALIES
B. EDEMA
C. INFLAMMATIONS
D. ANOMALIES & POSITION OF EYELIDS
E. TUMORS

8. A. CONGENITAL ANOMALIES

9. A. CONGENITAL ANOMALIES
I. Able-pharon: Macrostomia syndrome Extremely rare,
the lid is not developed autosomal recessive
genetic disorder .
ii. Micropharon : Rare, lids are abormally small
ii. Micropharon : Rare, lids are abormally small
iii. Cryptopharon:: Rare anomaly in which a fold of skin passes
from the eyebrow over the malformed eye to the cheek.
iv. Ptosis: Common, drooping of eyelid

10. v. Epicanthus : A vertical fold of skin on either side of the nose
sometime covering the inner canthus.
(the outer or inner corner of the eye )
vi. Distichiasis: an additional row of lashers
occupies the position of meibomian glands .abnormal growth of
lashers.
vii. Coloboma: condition where normal tissue in or around the
eye is missing from birth.

11. B. EDEMA
B. EDEMA

12.  A swelling eyelid occurs when there is inflammation or
excess fluid ( edema) in the connective tissue
surrounding the eye.
 Common due to looseness of tissues
 Inflammatory Edema: Found in conjunctivitis, tarsitis,(
infl of gland and lasher ) dacryo-cystitis, ( inflammation
of lacrimal sac )orbital cellulitis, ( inflammation of eye
tissue ) drug allergy (atropine).
tissue ) drug allergy (atropine).
 Passive edema: common feature of cavernous sinus
thrombosis ( formation of blood clot with in the
cavernous sinus a cavity at the base of the brain which
drains deoxygenated blood from the brain back to the
heart ), CHF, Nephrotic syndrome, hypoprotenemia &
anemia.

13. C. INFLAMMATIONS

14. It includes
1. Blepharitis
2. Hordeolum (stye)
3. Chalazion (tarsal or meimobian cyst)
3. Chalazion (tarsal or meimobian cyst)
4. Internal . Hordeolum

15. BLEPHARITIS
Is an inflammation of the eye lids in which they
become red, irritated and itching dandruff like
scales from on the eyelashes…

16. 1. BLEPHARITIS
Squamous blepharitis
Ulcerative blepharitis
1. SQUAMOUS BLEPHARITIS
: it is due to abnormal metabolism (abnormal
: it is due to abnormal metabolism (abnormal
chemical in body ) & seborrhea usually
associated with the dandruff of the scalp.
Numerous white coloured small scales
accumulate among the eyelashes.

17. 2. ULCERATIVE BLEPHARITIS
it is an ineffective condition. The yellow crusts
glue ( sticky) the lashes together. On removing
the crust there are small ulcers seen around
the bases of lashes.
the bases of lashes.
Symptoms: itching, redness, soreness,
lacrimation and photophobia.

18. Treatment
 Local: - removal of scales , crusts & diseased lashes is
done by bathing lid margin with 3% of NaHCO3 (
sodium bicarbonate ) lotion.
- antibiotics & ointment are applied.
 General : Improvement of general health & personal
 General : Improvement of general health & personal
hygiene.
- Dandruff of the scalp is to be adequately
treated.

19. 2. Hordeolum (Stye):is a localized infection or
inflammation of the eye lid margin involving hair follicles of
eyelashers or meibomian gland (supply of meibumian, an oily
substance )
Etiology: Associated with staphylococci infection, .
Common in young adults & debilitated persons( very week
person).
Symptoms: Ac. Pain & tenderness over inflamed Zeis’s gland.
Signs: Localized Pain, redness & edema near the lid margin.
Signs: Localized Pain, redness & edema near the lid margin.
Treatment: Hot fomentation, ( to apply a warm compressor eye )Evacuation
of pus,
antibiotic eye drop = tobramycin = it is killing or slow the growth of certain
type of bacteria.
& ointment & broad spectrum antibiotics is useful.
- Analgesics & anti-inflammatory drugs control pain & inflammation.

20. =
3. Chalazion: It is chronic granulomatous inflammation ( produced in
response to infection, inflammation,) or the presence of a foreign
substance. of mei-bomian gland.
Etiology: due to chronic irritation due to organism of low virulence (The
ability of bacteria to cause disease )where the glandular tissue is replaced
by granulation tissue containing giant cells.
- Occur in crops, more common in adults.
Symptoms : No pain unless secondary infected
Signs: Small non tender hard swelling slightly away from and swelling lid
Signs: Small non tender hard swelling slightly away from and swelling lid
margin ,swelling is red or purple, can be grey in later stages, yellow when
secondary infected with pyogenic organisms.
Treatment:
.
b) Inj. Triameinolone directly into the chalazion cause
complete resolution.
It prevents the release of substances in the body that cause inflammation.

21. 4. Internal Hordeolum : It is an acute Supportive
inflammation ( formation of pus )of mei-bomian glands
Etiology: Occurs due to secondary infection (occurs during or
after treatment for another infection.) of chalazion.
Symptoms : More violent than stye because the gland is larger
& embedded deeply in the dense fibrous tissue.
Sign : Yellow spot (pus) seen shining through the conjunctiva on
averting ( remaining) the lid;
TREATMENT
TREATMENT
Warm compresses an d massages of the lesions for 10
minutes 4 times per day
Tropical anti biotic ointment
Amoxicillin
Doxycycline
Erythromycin

22. D. ANOMALIES & POSITION OF
EYELIDS

23. It includes
1.Trichiasis, abnormally positioned eyelashes
2.Entropion, the lid margin rolls inwards
3.Ectropion, lid margin rolls outwards
4. Symblepharon, the adhesions between lids
and the globe.
and the globe.
5. Ankyloblepharon, adhesion of the margins of
two eyelids
6. Lago-pthalamus, inability to close the eyelids
completely.
7. Ptosis. drooping of the upper lid

24. D. ANOMALIES & POSITION OF EYELIDS
It includes Trichiasis, Entropion, Ectropion, Symblepharon, Ankyloblepharon,
Blepharophimosis, Lagopthalamus, Ptosis.
1. TRICHIASIS : abnormally positioned eyelashes Few lashes or whole lid
margin involved.
Etiology: Recurrent stye, Ulcerative blepharitis, Tight bandaging, Scars of
lid following burn, injury or operation.
lid following burn, injury or operation.
Symptoms
a) Foreign body sensation of photophobia due to corneal involvement
b) Irritation, pain & lacrimation
c) Treatment
d) Trichiasis treatment involves removing the eyelash, follicle or both, or
redirecting eyelash growth.

25. 2. ENTROPION: Conditions in which the lid margin rolls inwards.
Etiology
a) Spastic entropion: Due to the spasm of orbicularis oculi muscle as may
occur after tight bandaging after operation of following irritative corneal
condition
b) Cicatricial entropion :, ulcerative blepharitis, burns, operations,
diphtheritic membranous conjunctivitis.
Sign & symptoms : Same as for trichiasis
Treatment
Treatment
A. Spastic
 Basic cause of blepharospasm is treated
 If due to prolonged & tight bandaging,
discontinue it.
Antibiotics
Anti inflammatory - corticosteroids
Botulinum toxin –using eyelid spasms

26. 3. ECTROPION : It is a condition in which lid margin rolls
outwards
Symptom : Most common epiphora
excessive watering of the eyes
Signs
i) Conjunctiva become dry in appearance
ii) Chronic conjunctivitis & corneal ulcers.
iii) TREATMENT
iv) Use of lubricating ointment or mild steroid several day and
weeks to ectropion repair corneal epithelium ,,,

27. 4. SYMBLEPHARON : It is a condition of the adhesions
between lids and the globe.
Etiology : due to
- burns, ulcers, diphtheria, operation
Symptoms
1. Lagopthalamus: inability to close lids properly
2. Diplopia : double vision
3. treatment
4. Lysis and removal of subconjunctival scar tissue

28. 5. 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
grafting is recommended
- Separation of lid margins along with mucus membrane or conjunctival
grafting is recommended

29. 7. 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 ,proptosis (abnormal protrusion or
displacement of an eye , paralysis , absence of reflex, blinking in extremely
displacement of an eye , paralysis , absence of reflex, blinking in extremely
ill patient’s
Treatment
1. Application of antibiotic eye ointment & bandage during sleep is
recommended.
2. Levofloxacin

30. 8. PTOSIS
It is a condition in which there is drooping of the upper lid below its normal
position .
Etiology
1. Congenital Ptosis: Occurs in 80 % cases, due to maldevelopment of levator
muscle; congenital weakness of superior rectus muscle.
2. Acquired Ptosis : a). Neurogenic : partial/ complete paralysis of 3rd nerve
b) Mechanical : Due to increased weight of upper lid as a result of edema,
hypertrophy or tumor formation.
hypertrophy or tumor formation.
c) Myogenic : Due to trauma of levator muscle, muscular dystrophy (
increasing weakening or breakdown of muscle) & myasthenia gravis.(
neuromuscular disease weakness of skeleton muscle)
Symptoms : Visual disturbance
visible drooping of the upper eyelid

31. TRETMENT
high doses of opioid drugs such as morphine,
Morphine is a narcotic pain reliever used to
treat moderate to severe pain. ... 0.05 mg/kg
IM, IV, or subcutaneously every 4 to 8 hours
oxycodone hydrochloride analgesic agents
oxycodone hydrochloride analgesic agents
heroin, or hydrocodone can cause ptosis.
Pregabalin (Lyrica), an anticonvulsant drug,
has also been known to cause mild ptosis.[6]

32. E. TUMORS

33. 1. Benign Tumors
 Nevus
 Heman-gioma
 Papilloma
 Xanthe-lasma
Neurofibroma
 Neurofibroma
2. Malignant Tumors
 Squamous cell carcinoma
 Basal cell carcinoma

34. Nevus( mole on the skin red patches)
A choroidal nevus is a flat, benign pigmented
area that appears in the back of the eye
Heman-gioma
Heman-gioma
Hemangioma is a non-cancerous (benign)
tumor caused by abnormal growth of blood
vessels. cavernous hemangioma occurs in the
deeper layers of the skin or around the eye.

35. PAPILLOMA
a benign tumor derived from
epithelium. Papillomas may arise from skin,
mucous membranes, or glandular ducts
Xanthelasma
Xanthelasma
Are yellowish plaques that occur most
commonly near the inner canthus of the
eyelid, more often on the upper lid than the
lower lid. Xanthelasma

36. NEUROFIBROMA
It is a generalized disease that may involve the
lid & cause mechanical ptosis. It is associated
with unilateral infant glaucoma. Small, multiple
tumors are distributed along the hypertrophied
tumors are distributed along the hypertrophied
nerves.

37. Malignant Tumors

38.  Squamous cell carcinoma
 Basal cell carcinoma

39.  Squamous cell carcinoma
Seen at the edge of the lid (transition zone)
where the epithelium changes. It starts as a
nodule that ulcerate. The preauricular lymph
nodes are enlarged. It spreads slowly the
surrounding structures and are painless.
Metastasis ( spread of cancer cells to new area
of the body ) common,
of the body ) common,
 Basal cell carcinoma
It is most common seen in lower lid near the
inner canthus. It is locally malignant. Epithelial
growth spreads under the skin in all direction .

40. ETIOLOGY
Environmental toxins such as exposure to
radiation
Genetics
Diet – deficiency of minerals and vitamins
Stress excessive stress cause blocking mutation in
the cells of their developing eyes
Local trauma or injury- orbital trauma and
bleeding
Inflammation or infection

41. CLINICAL MANIFESTATION
Bulging of one eye (protrusion)
Complete and partial loss of sight
Pain in or around the eye
Blurred vision
Change in the appearance of the eye
Change in the appearance of the eye
Edema
Redness
Itching
Burning

42. DIAGNOSIS
Ultrasound scans
CT SCAN
MRI
They show the size , location ,and shape of
They show the size , location ,and shape of
the tumors and also show the enlarged or
affected lymph node around the eye.

43. MEDICAL MAANAGEMENT
1.Identify the cause & eliminate the cause
2. Achieve and maintain control of symptoms
3. Avoid adverse effects of medication.
4. to give antibiotics and anti inflammatory drugs .
5. Maintain normal activity level ,including exercise .
5. Maintain normal activity level ,including exercise .
6, Prevention foreign particles enter in eye
Use of sunglasses
To keep the eye clan ,wipe away the drainage
from around the eye ‘moisten and clan cotton ball
or wash cloth with warm water, from inner to the
outer part the eye.

44. MANAGMENT
Chemotherapy eye drops
Mitomycin C –are used to treat different types
of growths on the surface of the eye
fluorouracil
fluorouracil
Is used treatment pre-cancerous an cancerous
cell growth
Radiation therapy uses high energy x- rays or
other types of radiation kill the cancer cell.

45. THANKYOU