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