Disorders of malposition of the

lids Ayesha S Abdullah

06.09.2013

CATARACT

Recap

Glaucoma

Corneal opacity

Childhood blindnessmortality & morbidity

Vitamin A deficiency

Keratomalacia

Corneal xerosis

Bitot spot

Normal

Trachoma

Age-related macular degeneration

DIABETIC RETINOPATHY

What abnormality do you see?

Learning objectives

By the end of the lecture the students would be able to

Define the various disorders of malposition of the lids Classify ectropion, entropion & ptosis & correlate their

clinical presentation with the underlying structural and functional disorder

Identify the complications of ectropion, entropion & ptosis

Outline the management of ectropion, entropion & ptosis

Disorders of malposition of the lids Ectropion Entropion Ptosis Lagophthalmos

Trichiasis (disorder of eyelashes)

What are the factors responsible for the normal positioning of the eyelids ?

What are the factors responsible for the normal positioning of the eyelids ?

Tarsal plate Orbicularis oculi Lid retractors Medial and lateral canthal tendons

Clinical presentation Symptoms

Watering Itching and burning Physical appearance specific to the disorder

Signs Malposition of the lid margin Red eyes Keratinized conjunctiva Corneal signs; punctate staining Snap test for lid laxity

Ectropion Definition Outward rolling of the lid margin is called

ectropion Types Congenital Acquired

Involutional Cicatrical Paralytic Mechanical

INVOL.

CICATRICAL

PARALYTIC

MECHANICAL

Ectropion Complications

Conjunctival Corneal

Ectropion Management Medical

Lubricants; artificial tears and lubricating ointments

A protective eye shield worn at night to prevent drying

Temporary taping of the lid Surgical

Entropion Definition

Inward rolling of the eyelid margin What is inward turning of the eyelashes called?

Types Congenital Acquired

Involutional Cicatrical Spastic

Complications Conjunctival Corneal

Management Medical

Lubricants; artificial tears and lubricating ointments A protective eye shield worn at night to prevent drying

Surgical

Ptosis Definition Drooping of the upper eyelid Types:

Congenital Acquired

Neurogenic Myogenic Aponeurorotic Mechanical

NoMAM

Ptosis Clinical evaluation

Amount of ptosis Function of Levator Palpebrae Superioris Bell’s phenomenon

Complications Amblyopia in children

Treatment Surgical

Diagnosis

Complication ?

Photo Quiz

Jaw Winking