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
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