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Nerve/muscle for lid opening?
Levator and Muller's : CNIII
Nerve muscle for lid closing?
obicularis oculi: CNVII
Meibomian, Zeiss, Moll, Kraus-Wolfring, pilosebaceous glands?
- M- sebaceous
- Z- sebaceous
- Mo- sweat
- K- lacrimal
- P- sebaceous + hair follicle
What is Trichiasis?
abnormal, misdirected growth of eyelashes
Sx of Trichiasis?
- Corneal epithelial defects
- red eye
- discomfort, tearing
- FB sensation
Complications of Trichiasis?
- corneal abrasions
- pannus, infection and ulceration
Tx of Trichiasis?
- treat underlying cause
- epilation- pull hair out
- electrolysis- kill hair follicle
- laser surgery
What is Distichiasis?
extra row of eyelashes growing from the meibomian glands
What is congenital distichiasis?
differentiation of pilosebaceous glands/abnormal meibomian glands
What is acquired distchiasis?
transformation of meibomian glands to pilosebaceous glands
Tx of distichiasis?
- surgical excision
- laser extra lashes
- Lid splitting procedure: divide ant/post lamellae, cryo post, attach
Loss of eyelashes
loss of pigmentation in eyelashes and eyebrows
abnormally long eyelashes
What is a ptosis?
downward sagging of eyelid
What are the two types of anterior blepharitis?
Staph bleph cause?
- S aureus and S epidermis reaction
- inflammation of lid margins
Sx anterior bleph?
- red eye
- corneal infiltrates
- burning grittiness
- mild photophobia
- crusting and redness of lid margins
Signs of staph bleph?
- hard scales and crusting around the base of the lashes
- notching and ulceration of lid margin
- madarosis, trichiasis and poliosis
- hyperaemia, telgiectasia
Signs of seborrheoic bleph?
- lid margin oil
- lashes stick together
- soft scales
- association with meibomian gland dysfunction- changes in secretions
- association with DE/tear film
Sx of post bleph?
- meibomian gland orafices
- tear film is oily and froamy
Tx of bleph?
- lid hygiene and warm compresses
- tear substitutes
Lice on eyelashes? Sx and Tx?
- Sx: redness, itching, fb sensation, bleeding of margins
- Tx: smother with vaseline
Impetigo? sx and tx?
- seen in children
- sx: red skin, vesicles (fluid filled blisters)- rupture to form yellow crust
- tx: antibiotics
Erysipelas sx, dx, tx?
- sx: well defined, indurated, tender red plaque, spreading cellulitis
- tx: antibiotics
Necrotising facilitis sx and tx?
- redness, swelling, oedema, gangrene
- surgery antibiotics
Preseptal cellulits sx and tx?
- infection anterior to septum
- unilateral, redness, tender, swollen
DDX preseptal cellulitis?
dacryocytitis, hordeolum, orbital cellulitis
Differences in preseptal and orbital cellulitis?
orbital: painful eye movements, proptosis, fever, loss of vision
sensitivity to topical medication
Contact dermatitis sx and tx?
- tearing, itching, Red eye, uni/bi, lid oedema, no pain, crusting, thickening of lids
- identify allergen and remove, use drops w/o preservatives, antihistamines and cold compresses
Atopic dermatitis sx and tx?
- - chronic itching and scratching, thickening of eyelid skin
- - low dose steroid, moisturise skin