EYELIDS- INFECTIONS, TUMORS AND DEFORMITIES
- Is an infection of the sebaceous glands in the lid margin.
- Common bacterial infective agent - staphylococcus aureus.
- C/F- Red swollen circumscribed & acutely tender area develops rapidly.
- Treatment- Application of warm, moist compresses at least 4 times per day is beneficial. Antibiotic ointments or drops.
- Chronic inflammatory granuloma of the sebaceous (meibomian) glands in the lid.
- It may evolve from a hordeolum.
- Usually appears on the upper lid as a swollen, tender reddened area that may be painful.
- Treatment is similar to hordeolum
- Surgical removal of lesion as well as Injection with corticosteroids
- Chronic bilateral inflammation of the lid margins, caused by staphylococcal infection
- The lids are red rimmed with many scales or crusts on the lid margins & lashes.
- C/F- itching, burning, irritation & photophobia
There are many deformities that can affect the eyelids. These can be congenital, acquired or posttraumatic.
Common deformities include the following:
- Ectropion- turning out of the eyelid Entropion- turning in of the eyelid
- Lid retraction - pulling of the lower eyelid downward or upper eyelid upward
- Telecanthus -abnormally long distance from the inside corner of the eye to the nose
- Lid retraction
Abnormally high position of upper lid with rim of sclera visible above the cornea. Most commonly a sign of thyroid disease (50% of patients will be euthyroid).
Abnormally long distance from the inside comer of the eye to the nose
- Ectropion -
- When the lower eyelid turns outwards, it hangs away from the eyeball forming a kind of a bucket or a pocket around the eye.
- Though it does not cause any problem in general, but when the tears start collecting, this bucket overflows making the lower eyes water continuously.
- On the other hand, this makes the middle part of the eye exposed, thereby making it dry and irritated and more prone to eye infections.
l . Cicatricial ectropion- contracture or loss of eyelid skin by burns, trauma, infection etc.
2.Paralytic ectropion- Paralysis of the Orbicularis Oculi muscle which closes the eye.
3.Senile ectropion- results from stretching of the lower eyelid tissues in old age.
4.Mechanical ectropion- by tumour or thickening of the lower eyelid, which by its weight pulls the eyelid away from the eyeball
- The Z plasty- If there is only a localised linear scar it may be possible to release the contracture caused by the sear with a Z- plasty
- Skin graft - If there is an extensive loss of skin
- Tarsorrhaphy- closes the eyelids with sutures
4. Entropion --
- Both, upper and lower, lids turn inwards
- This leads to the eye lashes rubbing the eye ball, resulting in irritation in the eye, which may feel painful and watery.
- Also cause damage to the sclera or the cornea, which might further turn into an ulcer resulting in the loss of vision.
l . Contracture of the tarsal conjunctiva and distortion of the tarsal plate
2. Laxity of the connective tissue and the tarsal plate of the lower lid in old age
l . To remove the lashes.
- Cutting the lashes
- Excision of lash follicles or small clumps of lashes
2. To operate to alter the direction of the lashes, and correct the deformity in the tarsal plate.
Means a drooping of the upper eyelid
A congenital abnormality of the levator muscle which elevates the upper lid.
A paralysis of the third cranial nerve supplying the levator muscle
A paralysis of the cervical sympathetic nerve supplying Muller's muscle/ tarsal muscle
Senile stretching of the insertion of the levator muscle into the upper lid.
Myopathy or myasthenia affecting the levator muscle.
Trauma to the upper lid.