Lids & Lashes

Baby picture of the day!

Trichiasis Inward-turned eyelashes

Madarosis Missing eyelashes

Dermatochalasis Weakened orbital septum causes sagging eyelid skin

Ptosis/pseudoptosis

Superior visual field loss

Blepharitis Staph blepharitis – discharge, morning crusting

Seborrheic blepharitis – eyelash flakes

Hordeolum Acute staph infection of glands

Tender Internal – meibomian glands

External – Zeis/Moll glands (“stye”)

Chalazion Chronic sterile inflammation of meibomian gland

Hard Painless

Recurrent: think sebaceous gland carcinoma

Ectropion / Entropion Eyelid oriented away from globe

Concerns: exposure keratopathy, epiphora

Eyelid oriented toward the globe

Concerns: trichiasis

Floppy Eyelid Syndrome Lid eversion during sleep

Associated with sleep apnea in obese men

Morning redness & SPK

Benign Essential Blepharospasm (BEB) Bilateral involuntary closure of eyes

Orbicularis oculi, procerus, AND corrugator

Idiopathic

Myokymia Involuntary unilateral twiching of eyelids

Orbicularis oculi only

Causes: sleep deprivation, caffeine, stress

Malignant Eyelid Tumors Basal Cell Carcinoma (BCC)

Squamous Cell Carcinoma (SCC)

Sebaceous gland carcinoma

Malignant melanoma

Basal Cell Carcinoma (BCC) #1 eyelid cancer Malignancy of basal cell layer of epidermis

Risk factor: sun Pearly nodule, telangiectasia

“Rodent ulcer”

Squamous Cell Carcinoma (SCC) #2 eyelid cancer

More dangerous than BCC

Associated with actinic keratosis (elevated, red, scaly lesion)

Sebaceous Gland Carcinoma Neoplasm of sebaceous glands (meibomian & Zeis)

Associated with recurrent chalazia

Madarosis

Malignant Melanoma Most lethal primary skin cancer

Malignancy of melanocytes

Signs of Malignancy ABCDE:

Asymmetry Border irregularity

Color differences

Large diameter Enlargement