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What is ectropion?
turning of eyelid away from globe
signs and sx of involutional ectropion?
eyelid rolling outwards, epiphora, redness
What is a cause of involutional ectropion?
- laxity of lids, canthal tendons
- lid retractor problems
- degeneration of fibrous and elastic tissues
sign and sx of cicatricial ectropion?
scarring or contraction of skin pulling away form globe
What are some causes of cicatricial ectropion?
burns, trauma, dermatitis (bi), steven johnson's
What is a cause and tx of mechanical ectropion?
- caused by bump- tumour
- remove cause if possible and correct loose horizontal lid
What are some tx for ectropion?
- temp- tear subs, tape lid up
- surgical- canthoplasty, skin graft- scarred
What are some signs and sx of entropion?
- ocular irritation, redness, watery/mucous discharge
- lashes turned in, corneal abrasion, inward turning of lower lid
what are some signs and symptoms of involutional entropion?
- redness, irritation, corneal abrasion, excess tearing
- long term, ulceration and pannus
What is the cause of involutional entropion?
- horizontal lid and canthal tendon laxity,stretching
- overiding of preseptal over pretarsal obicularis
Sx, cause, and tx of cicatricial entropion?
- scarring of palp pulls lid margin towards globe
- causes: conjunctivitis, trachoma, chemical burns, SJS
- tx: remove inward turning lashes- bandage cl, graft to replace scarr
What is an eyelid ptosis?
What are some methods to measure ptosis?
- vertical lid fissure height
- upper lid excursion
How is vertical lid fissure height measured?
- distance between upper and lower lid margins
- normal upper- 2mm below upper limbus
- normal lower- 1mm above lower lumbus
How to measure MRD?
- dx between upper lid margin and light reflex
- mild: 4mm
- moderate: 3
- severe: <3
HOw to measure upper lid excursion?
- thumb against brow, eyes in downgaze, px looks up, refelcts levator function
- normal: >14
- good: >11
- fair: 5-11
- poor: <5
What is a brow ptosis?
excessive eyebrow skin
What is dermatochalasis?
excessive eyelid skin
What is a simple congenital ptosis?
- seen after birth
- poor levator function
- rx and amblyopia
- stretching of levator aponeurosis
- fatigue of muller
- lid/orbit tumours
- lid edema
- anterior lesions
What are some egs of pseudoptosis?
- globe misplacement
- mechanical lid displacement
- lid retraction of other eye
What are some egs of neurogenic ptosis?
- 3rd nerve palsy
- myasthenia gravis
What is horner's syndrome?
- pupillodilator dysfunction
- damage to sympathetic pathway
What are some sx of horner's?
ptosis, miosis, heterochromia, anhydrosis
What are some main signs of 3rd nerve palsy?
ptosis, diplopia, EOM defects
What are some causes of 3rd nerve palsy?
- compression due to tumours, intracranial pressure, aneurysm
What is the cause behind marcus-gunn?
connection between CV and CIII
What are some sx of myasthenia gravis?
- ptosis: bi, asym, worse with fatigue, upgaze
- diplopia: vertical
- NO PUPILS
- affects young women
Floppy eyelid syndrome?
- middle age, overweight males sleeping face down
- sleep apnoea
- redundant upper lid skin, loose, rubbery tarsal plates