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من طرف **7oda** السبت أغسطس 28, 2010 5:42 pm

THE EYELID

Eyelid divided by grey line into
Ant. Lamella composed

1. Skin
2. Orbicular is muscle

Post. Lamella composed

1. Tarsal plate (give D shape for eyelid and called skeleton of eyelid)
2. Conjunctiva
Structures of eyelid
Skin
Subcutaneous tissue
Orbicular is oculi muscle
Levator palpebrae superioris M
Muller muscle
Lower lid retractor
Tarsal plate
Glands

1. Meibomain gland (modified sebaceous gland)
2. Gland of zeis (modified sebaceous gland)
3. Gland of moll(modified sweat gland

blood supply

ophthalmic and lacrimalarteries by medial and lateral braches
venous drainage through the ophthalmic vein
nerve supply
orbicular is supply by 7th facial nerve
muller ms sympathetic
levator by oculomotor nerve
sensory Ns upper lid 5th ophthalmic
the lower lid Infraorbital N
lymphatic drainage
upper and lateral canthus (perauricular LN)
lower and medial canthus submandibular LN

the orbicular is MS
1. palpebral part

action this part blinking

2.orbital part

Action this part tight closure eye

3.lacrimal part

Contraction and pressure on sac

All parts supply by facial nerve
Patient with facial palsy come with
Lagohthalmos(can not close the eye by lid)
Ectropian(eyelid down by gravity)
Levator muscle
Nerve supply by oculomotor N
Paralysis of oculomotor =ptosis
Muller muscle sympathetic
Paralysis in sympathetic
Give partial ptosis
the lid margin two part
1.lacrimal part
2. Ciliary part
Grey line in front the Meibomain gland
White line opening the Meibomain duct
Congenital anomalies of eye lid

Epicanthus : concave fold of skin at nasally
Blepharophimosis syndrome(slide in EXAM)

AD CONSIST FROM THIS THINGS :
I. Narrowing palpebral fissure
II. BILATERLA Ptosis
III. Epicanthus
IV. Telecanthus
V. Ectropian of lower lid
VI. POOR LEVATOR

Trichiasis
Common acquired condition
More than 4 eyelashes misdirection backward against the cornea and conjunctiva
Causes
1.Primary
Blepharitis (special ulcerative form )
Recurrent hordeolum
Trauma related to lid margin
2.secondary
Herpes zoster
Trachoma
Symptom (ركز واحد في عين شعرا شنو بحس يا تري
F.B sensation
Photophobia due to irritation of cornea
Pain
Lacrimation
Conj. Congestion
Signs
Reflex blepharospasm
Misdirection eyelashes
Punctuate epithelia erosion

COMPLICATIONS
Corneal ulcer
Pannus and vascularisation
Treatment
Epilation or removal misdirection eyelashes
Electrolysis destruction of hair follicle
Cryotherapy
Argon laser
Surgical resection
Districhiasis
Extra row of lashes posterior to the normal lashes
Causes
Congenital
Acquired (cicatrizing Conj. As trachoma and chemical burn

D.D of trichiasis from pseudo – trichiasis in entropion
Lash.poliosis

localized premature whitening of lashes
cause

chronic anterior Blepharitis
[b]• Sympathetic ophthalmitis

VKH syndrome
Waardenburg syndrome

Madarosis
Partial or complete lose of lashes
Local cause
Anterior Blepharitis
Cicatrizing conjunctivitis
Iatrogenic
Systemic
Alopecia
Hypothyroidism
Syphilis or leprosy

Polytrichiosis (excessive numbers of eyelashes)
Trichiomegaly (abnormally large of lash)
[center]Chronic marginal Blepharitis

Classification
Anterior Blepharitis
Ulcerative Blepharitis
Seborrhoeic Blepharitis
Mixed
Posterior Blepharitis
Meibomain seborrhea
Meibomainitis
Mixed Ant &Post
Another classification
Squameus Blepharitis ( Seborrhoeic Blepharitis )

Ulcerative B.
Parasitic B.
Angular B.
Predisposing factors
1.malnutrition 2.old age 3.D.M
4.Uncorreted error refraction (spasm meb. Gland oily +dustand dry =Blepharitis )
5.smoke .dust. high temp.
Note

Treatment of Blepharitis ointment (MCQ)21 day why???
THANK YOU
THIS
B MDS
ALI FARAJ M.
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