Congenital & Aquired anomalies

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sendzik
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143593
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Congenital & Aquired anomalies
Updated:
2012-03-25 03:35:54
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Congenital Aquired anomalies
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Congenital & Aquired anomalies
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  1. Epicanthal folds
    • What is it?
    • -Vertical fold conceals

    • Causes
    • -Asians- all ages, Caucasians- infants

    • Look for/Sx
    • -Pseudostrab

    • Treatment
    • -R.O.- strab,
    • pinch back fold, refer
  2. Coloboma
    • What is it?
    • -Notch/cleft in lid margin, rounded without lashes or glands

    • Causes
    • -Congenital, not hereditary. Uncommon

    • Look for/Sx
    • -Desiccation, scarring, tear film problems

    • Treatment
    • -R.O- limbal
    • dermoids, cranial dystoses

    • Tx- lacrilubeHS,
    • tears PRN, surgery
  3. Blepharophimosis
    • What is it?
    • -Smaller than normal palpebral fissure (20-22mm)

    • Causes
    • -Congenital, uncommon

    • Look for/Sx
    • -Often a
    • triad w/ ptosis, and epicanthus inversus
    • -telecanthus and
    • ectropian

    • Treatment
    • -surgery
  4. Euryblepharon
    Wide palpebral aperture
  5. telecanthus
    Large distance btwn medial canthi
  6. Hypertelarism
    Widely spaced orbits

    -Seen w/cranium formation anomalies

    - exposure keratitis
  7. Distichiasis
    Absence of meibomian glands- extra row of lashes

    • -Rare/familial
    • -can be acquired
    • -follicle forms in gland
    • -Trichiasis
  8. Tristichiasis
    3 rows of lashes
  9. Mongoloid slant
    Medial canthus is higher than later canthus

    -Asians

    -Down’s syndrome
  10. Congenital Ptosis
    • -Lid lower than normal
    • 1) autosomal dominant- 70%,
    • 2) SR palsy, LPS palsy, isolated SR palsy is very rare
    • 3)paradoxical CNIII innervations, congenital
    • 4)congenital Horner’s
    • 5) birthtrauma- not common
    • 6)neonatal Myasthenia Gravis

    • Look for/Sx
    • 1) check family, look for pupil absruction
    • 2) vertical tropia with ptosis
    • 3) marcus Gunn jaw winking- amblyopia in 20% of cases
    • 4)heterochromia irides

    • History, photos,
    • occlusion amblyopia

    • Tx:
    • -Surgical consult for amblyopia
  11. Ankyloblepharon
    • What
    • -Adhesions between upper and lower lids- Zipper

    • Cause/who
    • -Mucocutaneous disease

    • What to look for/Sx
    • -Pseudostrab

    • Treatment/R.O.
    • -Cyclosporine, surgery
  12. Symblepharon
    • What
    • -Adhesions of tarsal conj to bubar

    • Cause/who
    • -Significant inflammatory disease, Stevens Johnson, pemphugoid, alkali burn

    • What to look for/Sx
    • -As tarsal and bulbar conj heal

    • Treatment/R.O.
    • -Bid-qid breakage with glass rod cyclosporin
  13. Vitiligo
    • What
    • -Patchy pigmentation of skin

    • Cause/who
    • -Cocaine

    • What to look for/Sx
    • -Depigmentation of eyelashes (poliosis)
    • -Depigmentation of hair (alopecia)
  14. Entropion
    • What
    • -Eyelid margins turn inward, usually lower

    • Cause/who
    • 1) congenital- deformity of tarsal plate
    • 2) cicatricial- scarring
    • 3) spastic-contraction of palpebral orbicularis
    • 4) atonic (senile)- stretching of skin

    • What to look for/Sx
    • -Trichiasis-foreign body sensation, irritation, tearing, corneal problems

    • Tx:
    • 1)Surgery
    • 4)surgery
    • -R.O. anterior segment, foreign body, scar in palpebral conj
    • -evaluate laxity of lids
    • -treat active Dz- epilate, if epithelial defect then need antibiotic ointment
    • - argon laser, electrolysis
  15. Ectropion
    • What
    • -Lid margin turned outward

    • Cause/who
    • 1)Usually atonic- elderly
    • 2)cicatricial
    • 3)paralytic-CNVII (Bell’s), post trauma, surgery

    • What to look for/Sx
    • -Desiccation, discomfort, tearing, infection
    • -epiphora (puncta not in apposition)
    • - have patient open mouth if it gets worse it’s cicatricial

    • Tx:
    • -prevent discomfort, tearing, infection, keratinization
    • -artificial tears q1h, qid, ophthalmic ointment qhs
    • -CL bandage
    • -infection= ointment/drops
    • -tape lid, suture lid
    • -surgery

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