Lids Disease

China Medical University NO.4 Affiliated hospital Ophthalmology;

Ophthalmology hospital of China Medical University

Basic knowledge

Basic knowledge

Inflammations of the lids

• Hordeolum• Chalazion• Blepharitis• Virus palpebral dermatitis• Contact dermatitis of the lids

Hordeolum

• Etiology

– Most hordeola are caused by staphylococcal infections ,usually Staphylococcus aureus.

• Principal symptoms– Pain, redness and swelling

Symptoms

External External internalhordeolum hordeolum hordeolum

Treatment

• Warm compresses• Incision and drainage of the purulent

material• Antibiotic ointment• Systemic antibiotics are indicated if c

ellulitis develops

Chalazion

Etiology Meibomian plugging

Symptoms– Sterile chronic granulomatous inflammation– Localized swelling– Painless

Treatment– Warm compresses– Intralesional steroid injections– Surgical excision

Chalazion

Blepharitis

• Squamous blepharitis

• Ulcerative blepharitis

• Angular blepharitis

Squamous blepharitis

Etiology infection of pityrosporum ovaleSymptoms– Irritation,burning,and itching of the lid margins– Many scales or granulations– The scales are greasy,ulceration does not occ

ur,and the lid margins are less red.Treatment– The scalp ,eye brows and lid margins must be

kept clean– Scales must be removed daily– Eye ointment

Squamous blepharitis

Ulcerative blepharitisEtiology infection of staphylococcus aureusSymptoms– Irritation,burning,and itching – Many scales or granulations– The scales are dry,the lids are red,tiny ulcerat

ed areas are found along the lid margins,and the lashes tend to fall out.

Treatment– The scalp ,eye brows and lid margins must be

kept clean– Scales must be removed daily– Eye ointment

Angular blepharitis

Etiology infection of Morax-Axenfeld

Symptoms– Irritation,burning,and itching – The lateral canthus and lid margin sho

ws hyperemia and telangiectasia.

Treatment– Eye ointment– VB and VC

Tumors of the eyelids

• Benign lid tumors– Hemangioma– Nevus– Xanhelasma

• Primary malignant tumors of the lids– Basal cell carcinoma– Squamous cell carcinoma– Sebaceous gland carcinoma

Hemangioma

Nevus

•

•

Xanhelasma

Basal cell carcinoma

Squamous cell carcinoma

Sebaceous gland carcinoma

Anatomic deformities of the lids

• Trichiasis and aberrant lashes• Entropion • Ectropion• Lagophthalmus • Ptosis • Epicanthus • Distichiasis • Congenital coloboma of the lids

Trichiasis and aberrant lashes

• Impingement of eyelashes on the cornea

• Treament– Temporary relief Plucking the

offending eyelashes

– Permanent relief electrolysis, laser or knife surgery,or cryosurgery

Trichiasis

Entropion

• Classification– Congenital entropion– Spastic entropion– Cicatricia entropion

• Treament– Surgery– Tape the lower lid to the cheek– Inject botulinum toxin

Ectropion

• Classification– Cicatricia ectropion– senile entropion– paralytic entropion

• Symptoms– Tearing and irritation

• Treament– Surgery

Ptosis

• Etiology– Congenital Ptosis oculomoto

r nerve nucleus/levator maldevelopment

– Acquired Ptosis myogenic ptosis/neurogenic ptosis/mechanical ptosis

Ptosis

• Symptoms– Ptosis– Deep frontal fold– Amblyopia

• Treament • Congenital Ptosis surgery, revent

amblyopia

• Acquired Ptosis surgery

epicanthus

• Epicanthus is characterized by vertical folds of skin over the medial canthi

• Epicanthus tarsalis

epicanthus

• Epicanthus inversus

Congenital coloboma of the lids