The eyelidsThe eyelidsThe eyelids are the moving folds ofThe eyelids are the moving folds of

skin that cover the outer portion ofskin that cover the outer portion ofthe eyeball. Which protect the eyethe eyeball. Which protect the eyefrom injury and excessive light, andfrom injury and excessive light, andprevent excessive dryness of theprevent excessive dryness of thecornea and conjunctivacornea and conjunctiva

Macroscopic anatomy :Macroscopic anatomy :--11.. The palpebral fissureThe palpebral fissure22..The canthiThe canthi

The eyelids are the moving folds ofThe eyelids are the moving folds ofskin that cover the outer portion ofskin that cover the outer portion ofthe eyeball. Which protect the eyethe eyeball. Which protect the eyefrom injury and excessive light, andfrom injury and excessive light, andprevent excessive dryness of theprevent excessive dryness of thecornea and conjunctivacornea and conjunctiva

Macroscopic anatomy :Macroscopic anatomy :--11.. The palpebral fissureThe palpebral fissure22..The canthiThe canthi

Microscopic AnatomyMicroscopic AnatomyThe eyelid is formed ofThe eyelid is formed of 66 layers :layers :--11.. Skin &Subcutaneous tissueSkin &Subcutaneous tissue22.. Muscular layer of protractionMuscular layer of protraction33.. Orbital septumOrbital septum44.. Orbital fatOrbital fat55.. Muscle of retractionMuscle of retraction66.. Palpebral conjunctivaPalpebral conjunctiva

The eyelid is formed ofThe eyelid is formed of 66 layers :layers :--11.. Skin &Subcutaneous tissueSkin &Subcutaneous tissue22.. Muscular layer of protractionMuscular layer of protraction33.. Orbital septumOrbital septum44.. Orbital fatOrbital fat55.. Muscle of retractionMuscle of retraction66.. Palpebral conjunctivaPalpebral conjunctiva

The lid marginThe lid margin

It is aboutIt is about 22mm broadmm broadit had external and internal portion divided byit had external and internal portion divided by

gray line.gray line.it is divided intoit is divided into 22 portions :portions :--a.a. LacrimalLacrimal portion:portion: in which contentin which content lacrimallacrimal

papillaepapillae

b.b. CiliaryCiliary portion:portion: in which eyelashes arein which eyelashes arepresentpresent

It is aboutIt is about 22mm broadmm broadit had external and internal portion divided byit had external and internal portion divided by

gray line.gray line.it is divided intoit is divided into 22 portions :portions :--a.a. LacrimalLacrimal portion:portion: in which contentin which content lacrimallacrimal

papillaepapillae

b.b. CiliaryCiliary portion:portion: in which eyelashes arein which eyelashes arepresentpresent

The muscles of the lidThe muscles of the lid

11.. OrbicularisOrbicularis oculioculi muscle :muscle :--a. Orbital portion.a. Orbital portion.b.Palpebralb.Palpebral portionportionc. Hornerc. Horner’’s muscles muscle

22.. LavatorLavator palpebraepalpebrae superiorissuperioris musclemuscle((capsulopalpepralcapsulopalpepral))33. Muller. Muller’’s muscles muscle((inferior tarsal muscle)inferior tarsal muscle)

11.. OrbicularisOrbicularis oculioculi muscle :muscle :--a. Orbital portion.a. Orbital portion.b.Palpebralb.Palpebral portionportionc. Hornerc. Horner’’s muscles muscle

22.. LavatorLavator palpebraepalpebrae superiorissuperioris musclemuscle((capsulopalpepralcapsulopalpepral))33. Muller. Muller’’s muscles muscle((inferior tarsal muscle)inferior tarsal muscle)

The gland of the lidThe gland of the lid

1.1. Meibomian glandMeibomian gland2.2. Zeis glandZeis gland3.3. MollMoll’’s glands gland

1.1. Meibomian glandMeibomian gland2.2. Zeis glandZeis gland3.3. MollMoll’’s glands gland

Blood supply of the eyelidBlood supply of the eyelid

ArteriesArteries11.. InernalInernal carotid artery (ophthalmic &carotid artery (ophthalmic &lacrimal ).lacrimal ).

22.. External carotid artery (temporal andExternal carotid artery (temporal andangular).angular).

Branches from both systemsBranches from both systems anastomose toanastomose toform tarsal arcadesform tarsal arcades

ArteriesArteries11.. InernalInernal carotid artery (ophthalmic &carotid artery (ophthalmic &lacrimal ).lacrimal ).

22.. External carotid artery (temporal andExternal carotid artery (temporal andangular).angular).

Branches from both systemsBranches from both systems anastomose toanastomose toform tarsal arcadesform tarsal arcades

Veins:Veins:--

ophthalmic vein.ophthalmic vein.

LLymphatic drainageymphatic drainage ::--1.1. MedialMedial 11//33 drains to the subdrains to the sub

maxillary lymph nodesmaxillary lymph nodes2.2. LateralLateral 22//33 drain to the predrain to the pre

auricular and parotid lymph nodesauricular and parotid lymph nodes

ophthalmic vein.ophthalmic vein.

LLymphatic drainageymphatic drainage ::--1.1. MedialMedial 11//33 drains to the subdrains to the sub

maxillary lymph nodesmaxillary lymph nodes2.2. LateralLateral 22//33 drain to the predrain to the pre

auricular and parotid lymph nodesauricular and parotid lymph nodes

Nerve supply of eyelidsNerve supply of eyelids

11. Sensory : ophthalmic division of. Sensory : ophthalmic division ofthe trigeminal nerve(Vthe trigeminal nerve(V11) .) .

maxillary(Vmaxillary(V22) .) .22. Motor :. Motor : 33rd ,rd ,77th fibers supply theth fibers supply the

levatorlevator ,orbicularis respectively.,orbicularis respectively.

33. Sympathetic Muller’s muscle. Sympathetic Muller’s muscle

11. Sensory : ophthalmic division of. Sensory : ophthalmic division ofthe trigeminal nerve(Vthe trigeminal nerve(V11) .) .

maxillary(Vmaxillary(V22) .) .22. Motor :. Motor : 33rd ,rd ,77th fibers supply theth fibers supply the

levatorlevator ,orbicularis respectively.,orbicularis respectively.

33. Sympathetic Muller’s muscle. Sympathetic Muller’s muscle

Diseases of the lidsDiseases of the lids

1.1. Congenital anomalies of the lidsCongenital anomalies of the lids2.2. Inflammation of the lidsInflammation of the lids3.3. Deformities of the lid margin andDeformities of the lid margin and

palpebral aperturepalpebral aperture4.4. Tumours of the lidsTumours of the lids

1.1. Congenital anomalies of the lidsCongenital anomalies of the lids2.2. Inflammation of the lidsInflammation of the lids3.3. Deformities of the lid margin andDeformities of the lid margin and

palpebral aperturepalpebral aperture4.4. Tumours of the lidsTumours of the lids

Congenital Anomalies of EyelidsCongenital Anomalies of Eyelids

1.1. Ablepharon:Ablepharon: Deficiency of the anteriorDeficiency of the anteriorlamellae of thelamellae of the eyelidseyelids

2.2. MicroblepharonMicroblepharon characterized bycharacterized bysmall eyelidssmall eyelids

3.3. Cryptophthalmos:Cryptophthalmos: the lids arethe lids arereplaced by a layer of skinreplaced by a layer of skin

4.4. Ptosis abnormallyPtosis abnormally low position of thelow position of theupper lid which may be congenital orupper lid which may be congenital oracquiredacquired

1.1. Ablepharon:Ablepharon: Deficiency of the anteriorDeficiency of the anteriorlamellae of thelamellae of the eyelidseyelids

2.2. MicroblepharonMicroblepharon characterized bycharacterized bysmall eyelidssmall eyelids

3.3. Cryptophthalmos:Cryptophthalmos: the lids arethe lids arereplaced by a layer of skinreplaced by a layer of skin

4.4. Ptosis abnormallyPtosis abnormally low position of thelow position of theupper lid which may be congenital orupper lid which may be congenital oracquiredacquired

Ablepharon CryptophthalmosAblepharon Cryptophthalmos

55. Epicanthus:. Epicanthus: bilateral vertical folds ofbilateral vertical folds ofskin that extend from the upper orskin that extend from the upper orlower lids towards the medial canthilower lids towards the medial canthi

66.. DistichiasisDistichiasis: extra posterior row of: extra posterior row ofcilia is presentcilia is present

77.. ColobomaColoboma of the lid: a notch isof the lid: a notch isusually situated at the junction ofusually situated at the junction ofthe middle third and the medialthe middle third and the medialthirdthird

88.. EntropionEntropion andand EctropionEctropion

55. Epicanthus:. Epicanthus: bilateral vertical folds ofbilateral vertical folds ofskin that extend from the upper orskin that extend from the upper orlower lids towards the medial canthilower lids towards the medial canthi

66.. DistichiasisDistichiasis: extra posterior row of: extra posterior row ofcilia is presentcilia is present

77.. ColobomaColoboma of the lid: a notch isof the lid: a notch isusually situated at the junction ofusually situated at the junction ofthe middle third and the medialthe middle third and the medialthirdthird

88.. EntropionEntropion andand EctropionEctropion

Lid EdemaLid Edema

1. Traumatic edema

2. Inflammatory edema

3. Non inflammatory edema

a. Allergic angioneurotic edema

b. Passive systemic edema

1. Traumatic edema

2. Inflammatory edema

3. Non inflammatory edema

a. Allergic angioneurotic edema

b. Passive systemic edema

Inflammations Of The LidInflammations Of The Lid

AA-- Inflammations of the whole lidInflammations of the whole liditself (cellulitis or lid abscess)itself (cellulitis or lid abscess)

BB-- Inflammations of the lid marginInflammations of the lid margin((blepharitisblepharitis))

CC-- Inflammations of the glands of theInflammations of the glands of thelid (externallid (external hordeolumhordeolum, internal, internalhordeolumhordeolum andand chalazionchalazion))

AA-- Inflammations of the whole lidInflammations of the whole liditself (cellulitis or lid abscess)itself (cellulitis or lid abscess)

BB-- Inflammations of the lid marginInflammations of the lid margin((blepharitisblepharitis))

CC-- Inflammations of the glands of theInflammations of the glands of thelid (externallid (external hordeolumhordeolum, internal, internalhordeolumhordeolum andand chalazionchalazion))

AA-- LID ABSCESSLID ABSCESSIt is a localizedIt is a localized suppurativesuppurative

inflammation of the lidinflammation of the lidClinical picture: A painful, red, hot andClinical picture: A painful, red, hot and

tender swelling within the lid.tender swelling within the lid.Treatment:Treatment:•• Systemic and local antibioticsSystemic and local antibiotics•• Surgical drainage by a transverseSurgical drainage by a transverse

incision at pointing point of pusincision at pointing point of pus(better cosmetically). Vertical incisions(better cosmetically). Vertical incisions

should be avoided as they may leadshould be avoided as they may leadto shortening on fibrosisto shortening on fibrosis

It is a localizedIt is a localized suppurativesuppurativeinflammation of the lidinflammation of the lid

Clinical picture: A painful, red, hot andClinical picture: A painful, red, hot andtender swelling within the lid.tender swelling within the lid.

Treatment:Treatment:•• Systemic and local antibioticsSystemic and local antibiotics•• Surgical drainage by a transverseSurgical drainage by a transverse

incision at pointing point of pusincision at pointing point of pus(better cosmetically). Vertical incisions(better cosmetically). Vertical incisions

should be avoided as they may leadshould be avoided as they may leadto shortening on fibrosisto shortening on fibrosis

BB-- BLEPHARITISBLEPHARITISBlepharitis usually presents as aBlepharitis usually presents as a

chronic blepharoconjunctivitis andchronic blepharoconjunctivitis andit is the most common external eyeit is the most common external eyedisorder in clinical practicedisorder in clinical practice

Types:Types:1.1. Anterior blepharitis.Anterior blepharitis.2.2. Posterior blepharitis.Posterior blepharitis.

Blepharitis usually presents as aBlepharitis usually presents as achronic blepharoconjunctivitis andchronic blepharoconjunctivitis andit is the most common external eyeit is the most common external eyedisorder in clinical practicedisorder in clinical practice

Types:Types:1.1. Anterior blepharitis.Anterior blepharitis.2.2. Posterior blepharitis.Posterior blepharitis.

11. Anterior Blepharitis. Anterior Blepharitis

AA-- staphylococcalstaphylococcal blepharitisblepharitis-- hard scales and crusting around the basehard scales and crusting around the baseof lashes.of lashes.-- mild papillary conjunctivitis.mild papillary conjunctivitis.-- scarring and notching of lid margin,scarring and notching of lid margin,madarosismadarosis,, trichiasistrichiasis andand poliosispoliosis..-- corneal marginal keratitis.corneal marginal keratitis.-- tear film instability and dry eye.tear film instability and dry eye.

AA-- staphylococcalstaphylococcal blepharitisblepharitis-- hard scales and crusting around the basehard scales and crusting around the baseof lashes.of lashes.-- mild papillary conjunctivitis.mild papillary conjunctivitis.-- scarring and notching of lid margin,scarring and notching of lid margin,madarosismadarosis,, trichiasistrichiasis andand poliosispoliosis..-- corneal marginal keratitis.corneal marginal keratitis.-- tear film instability and dry eye.tear film instability and dry eye.

BB-- Seborrhoeic BlepharitisSeborrhoeic Blepharitis

-- Hyperaemic and greasy anterior lidHyperaemic and greasy anterior lidwith sticking together of lashes.with sticking together of lashes.

-- The scale are soft and locatedThe scale are soft and locatedanywhere on the lid margin andanywhere on the lid margin andlashes.lashes.

-- Hyperaemic and greasy anterior lidHyperaemic and greasy anterior lidwith sticking together of lashes.with sticking together of lashes.

-- The scale are soft and locatedThe scale are soft and locatedanywhere on the lid margin andanywhere on the lid margin andlashes.lashes.

TreatmentTreatment

Lifelong treatment may be necessary andLifelong treatment may be necessary andthat a permanent cure is unlikely:that a permanent cure is unlikely:

11-- Lid hygiene.Lid hygiene.22-- Antibiotics:Antibiotics:

aa-- topical: like sodium fusidic acid,topical: like sodium fusidic acid,bacitracin or chloramphenicolbacitracin or chloramphenicolbb-- oral: like azithromycinoral: like azithromycin 500500 mg for threemg for threedays.days.

33-- Weak topical steroid.Weak topical steroid.44-- Tear substitute.Tear substitute.

Lifelong treatment may be necessary andLifelong treatment may be necessary andthat a permanent cure is unlikely:that a permanent cure is unlikely:

11-- Lid hygiene.Lid hygiene.22-- Antibiotics:Antibiotics:

aa-- topical: like sodium fusidic acid,topical: like sodium fusidic acid,bacitracin or chloramphenicolbacitracin or chloramphenicolbb-- oral: like azithromycinoral: like azithromycin 500500 mg for threemg for threedays.days.

33-- Weak topical steroid.Weak topical steroid.44-- Tear substitute.Tear substitute.

Posterior BlepharitisPosterior BlepharitisIs caused by meibomian gland dysfunction and alterationIs caused by meibomian gland dysfunction and alteration

in meibomian gland secretion.in meibomian gland secretion.

-- Excessive and abnormal meibomian gland secretionExcessive and abnormal meibomian gland secretion-- Plugging of the meibomian gland orifices.Plugging of the meibomian gland orifices.-- Expression of meibomian fluid by pressure.Expression of meibomian fluid by pressure.-- Tear film is oily.Tear film is oily.-- Papillary conjunctivitis and inferior corneal punctatePapillary conjunctivitis and inferior corneal punctate

epithelial erosions.epithelial erosions.

Is caused by meibomian gland dysfunction and alterationIs caused by meibomian gland dysfunction and alterationin meibomian gland secretion.in meibomian gland secretion.

-- Excessive and abnormal meibomian gland secretionExcessive and abnormal meibomian gland secretion-- Plugging of the meibomian gland orifices.Plugging of the meibomian gland orifices.-- Expression of meibomian fluid by pressure.Expression of meibomian fluid by pressure.-- Tear film is oily.Tear film is oily.-- Papillary conjunctivitis and inferior corneal punctatePapillary conjunctivitis and inferior corneal punctate

epithelial erosions.epithelial erosions.

TreatmentTreatmentInform the patient that cure is unlikelyInform the patient that cure is unlikely11-- Lid hygiene.Lid hygiene.22-- Systemic antibiotic.Systemic antibiotic.TetracyclineTetracycline forfor 66 --1212 week.week.aa-- OxytetracyclineOxytetracycline 250250 mgmg b.db.d..bb-- DoxycyclineDoxycycline 100100 mgmg b.db.d. for one week then. for one week then

once.once.cc-- MinocyclineMinocyclineOr Erythromycin in childrenOr Erythromycin in children33-- Topical therapy (A.B., steroid and tearTopical therapy (A.B., steroid and tear

substitute).substitute).

Inform the patient that cure is unlikelyInform the patient that cure is unlikely11-- Lid hygiene.Lid hygiene.22-- Systemic antibiotic.Systemic antibiotic.TetracyclineTetracycline forfor 66 --1212 week.week.aa-- OxytetracyclineOxytetracycline 250250 mgmg b.db.d..bb-- DoxycyclineDoxycycline 100100 mgmg b.db.d. for one week then. for one week then

once.once.cc-- MinocyclineMinocyclineOr Erythromycin in childrenOr Erythromycin in children33-- Topical therapy (A.B., steroid and tearTopical therapy (A.B., steroid and tear

substitute).substitute).

Inflammation of eyelids glandsInflammation of eyelids glands11.Stye: (External.Stye: (ExternalHordeolumHordeolum))

AcuteAcute suppurativesuppurative inflammation ofinflammation of ZeisZeisgland and the lash follicle, forming agland and the lash follicle, forming asmall abscesssmall abscess

Treatment: topical antibiotic, hotTreatment: topical antibiotic, hotcompresses and epilation of associatedcompresses and epilation of associatedlash.lash.

AcuteAcute suppurativesuppurative inflammation ofinflammation of ZeisZeisgland and the lash follicle, forming agland and the lash follicle, forming asmall abscesssmall abscess

Treatment: topical antibiotic, hotTreatment: topical antibiotic, hotcompresses and epilation of associatedcompresses and epilation of associatedlash.lash.

22. Internal. Internal HordeolumHordeolum

AcuteAcute suppurativesuppurative inflammation of theinflammation of themeibomianmeibomian gland caused bygland caused bystaphylococcusstaphylococcus aureusaureus. It may be. It may beprimary or it may occur on top of aprimary or it may occur on top of achronic inflammation of thechronic inflammation of themeibomianmeibomian gland (gland (chalazionchalazion))

Treatment: surgical drainage + A.B. .Treatment: surgical drainage + A.B. .

AcuteAcute suppurativesuppurative inflammation of theinflammation of themeibomianmeibomian gland caused bygland caused bystaphylococcusstaphylococcus aureusaureus. It may be. It may beprimary or it may occur on top of aprimary or it may occur on top of achronic inflammation of thechronic inflammation of themeibomianmeibomian gland (gland (chalazionchalazion))

Treatment: surgical drainage + A.B. .Treatment: surgical drainage + A.B. .

ChalazionChalazion ((meibomianmeibomian cyst)cyst)

It is chronicIt is chronic sterilesterile granulomatousgranulomatousinflammatory lesion result from retainedinflammatory lesion result from retainedsebaceous secretions leaking fromsebaceous secretions leaking frommeibomianmeibomian gland.gland.

Treatment:Treatment:--SpotaneousSpotaneous resolutionresolutionSurgerySurgerySteroid injectionSteroid injectionSystemic tetracycline (recurrentSystemic tetracycline (recurrent especialyespecialy inin

acne rosacea)acne rosacea)

It is chronicIt is chronic sterilesterile granulomatousgranulomatousinflammatory lesion result from retainedinflammatory lesion result from retainedsebaceous secretions leaking fromsebaceous secretions leaking frommeibomianmeibomian gland.gland.

Treatment:Treatment:--SpotaneousSpotaneous resolutionresolutionSurgerySurgerySteroid injectionSteroid injectionSystemic tetracycline (recurrentSystemic tetracycline (recurrent especialyespecialy inin

acne rosacea)acne rosacea)

Disorder of the lid andDisorder of the lid andpalpebral aperturepalpebral aperture

1.1. TrichiasisTrichiasis2.2. DDistichiasisistichiasis3.3. EntropionEntropion4.4. EctropionEctropion5.5. SymblepharonSymblepharon6.6. AnkyloblepharonAnkyloblepharon7.7. BlepharophimosisBlepharophimosis8.8. LagophthalmosLagophthalmos9.9. PtosisPtosis

1.1. TrichiasisTrichiasis2.2. DDistichiasisistichiasis3.3. EntropionEntropion4.4. EctropionEctropion5.5. SymblepharonSymblepharon6.6. AnkyloblepharonAnkyloblepharon7.7. BlepharophimosisBlepharophimosis8.8. LagophthalmosLagophthalmos9.9. PtosisPtosis

TRICHIASISTRICHIASIS

Posterior misdirection of lashes arising fromPosterior misdirection of lashes arising fromnormal site.normal site.

Etiology:Etiology:iisolated or as a result of margin scaringsolated or as a result of margin scaring

secondary to chronicsecondary to chronic blepharitisblepharitis & herpes& herpeszosterzoster ophthalmicusophthalmicus ..

(Differentiated from(Differentiated from pseudotrichiasispseudotrichiasis))

Posterior misdirection of lashes arising fromPosterior misdirection of lashes arising fromnormal site.normal site.

Etiology:Etiology:iisolated or as a result of margin scaringsolated or as a result of margin scaring

secondary to chronicsecondary to chronic blepharitisblepharitis & herpes& herpeszosterzoster ophthalmicusophthalmicus ..

(Differentiated from(Differentiated from pseudotrichiasispseudotrichiasis))

DistichiasisDistichiasisA partial or complete second row of lashesA partial or complete second row of lashes

emerging at or slightly behind theemerging at or slightly behind themeibomianmeibomian glandgland orificesorifices

1.1. Congenital asymptomatic tillCongenital asymptomatic till 55 yearyearoldold

2.2. Acquired secondary to cicatrizingAcquired secondary to cicatrizingconjunctivitisconjunctivitis

DistichiasisDistichiasisA partial or complete second row of lashesA partial or complete second row of lashes

emerging at or slightly behind theemerging at or slightly behind themeibomianmeibomian glandgland orificesorifices

1.1. Congenital asymptomatic tillCongenital asymptomatic till 55 yearyearoldold

2.2. Acquired secondary to cicatrizingAcquired secondary to cicatrizingconjunctivitisconjunctivitis

EntropionEntropionDefinition:Definition:is the inversion of lid margin. Theis the inversion of lid margin. The

whole row of the lashes will bewhole row of the lashes will berubbing against the cornea .rubbing against the cornea .

Types:Types:

1.1. CicatricialCicatricial entropionentropion2.2. SpasticSpastic entropionentropion3.3. InvolutionalInvolutional (senile)(senile) entropionentropion4.4. CongenitalCongenital entropionentropion

1.1. CicatricialCicatricial entropionentropion2.2. SpasticSpastic entropionentropion3.3. InvolutionalInvolutional (senile)(senile) entropionentropion4.4. CongenitalCongenital entropionentropion

ECTROPIONECTROPION

Definition:Definition:outward turning of the eyelid margin.outward turning of the eyelid margin.It usually affects the lower lid as itIt usually affects the lower lid as itstands against gravity.stands against gravity.

Definition:Definition:outward turning of the eyelid margin.outward turning of the eyelid margin.It usually affects the lower lid as itIt usually affects the lower lid as itstands against gravity.stands against gravity.

Types:Types:1.1. InvolutionalInvolutional (senile)(senile) ectropionectropion2.2. CicatricialCicatricial ectropionectropion3.3. ParalyticParalytic ectropionectropion4.4. MechanicalMechanical ectropionectropion5.5. CongenitalCongenital ectropionectropion

Types:Types:1.1. InvolutionalInvolutional (senile)(senile) ectropionectropion2.2. CicatricialCicatricial ectropionectropion3.3. ParalyticParalytic ectropionectropion4.4. MechanicalMechanical ectropionectropion5.5. CongenitalCongenital ectropionectropion

SymblepharonSymblepharon

A condition where adhesion developsA condition where adhesion developsbetween the lid and the eyeball.between the lid and the eyeball.DueDue

1.1. Membranous conjunctivitisMembranous conjunctivitis2.2. Chemical burns or ulcersChemical burns or ulcers3.3. OperationOperation

A condition where adhesion developsA condition where adhesion developsbetween the lid and the eyeball.between the lid and the eyeball.DueDue

1.1. Membranous conjunctivitisMembranous conjunctivitis2.2. Chemical burns or ulcersChemical burns or ulcers3.3. OperationOperation

AnkyloblepharonAnkyloblepharon

TheThe upper and lower eyelids areupper and lower eyelids arejoined by thinjoined by thin tagstags

BlepharophimosisBlepharophimosis

Is the narrowing of the palpebralIs the narrowing of the palpebralapertureaperture

Congenital conditionCongenital conditionPtosis ,epicanthus &Ptosis ,epicanthus & telecanthustelecanthus

Is the narrowing of the palpebralIs the narrowing of the palpebralapertureaperture

Congenital conditionCongenital conditionPtosis ,epicanthus &Ptosis ,epicanthus & telecanthustelecanthus