3. Entropion is abnormal inversion of the eyelid (usually the lower) toward the globe.
Causes corneal abrasions or Infections.
usually acquired as a result of involutional or cicatricial processes but may occasionally be
congenital.
TYPES
SPASTIC
CICATRICIAL
INVOLUTIONAL
4. Due to spasm of ORBICULARIS OCULI
CAUSES
Tight bandage post surgery
Chronic irritative corneal condition
Common in old people
Mostly lower lid is involved
5. mostly due to inward direction of lashes
Symptoms : foreign body sensation
,photophobia,irritation ,pain.
Signs: reflex blepherospasm if cornea is
involved
Corneal abrasion ,ulceration ,superficial
opacities
Conjunctival congestion
6. If due to bandage ;simply discontinue the
application of bandage
If senile patient ,the lower lid is pulled
downwards by strip of adhesive plaster
7. Cicatricial means new tissue that forms over a
wound and later contracts into a scar.
results due to contraction of palpebral
conjunctiva in;
Trachoma stage IV
Ulcerative blepharitis
Burns
Surgeries
Diphtheric membranous conjunctivitis
Radiotherapy
Ocular cicatricial pemphigoid
trauma
8. • Chronic: loss of plica semilunaris, loss of
forniceal depth, formation of
symblepharon/ankyloblepharon, dry eye
signs( redness ,lacrimation).
In trachoma, subtarsal fibrosis is likely to be
evident.
• Acute: papillary conjunctivitis,
subconjunctival vesicles.
9. Medical: the cicatrizing process should be optimally
controlled, especially before surgical intervention .
Principles of treatment through surgery are
Altering lash direction
Transplantation of lashes
Straightening the distorted tarsus
Treated by operative procedures
1. Resection of skin and muscle
2. Resection of tarsus, skin and muscle
3. Burow`s operation.
10. Congenital entropion
very rare
often resolves with time, without the need
for intervention.
Pretarsal orbicularis is hypertrophied,
forming a marked ridge.
the lashes do not usually damage the cornea
recurrent infections are common.
26. ACTIVE OR INFLAMMATORY EDEMA
I. External hordeolum
II. Internal hordeolum
III. Insect bite
IV. Dermatitis
PASSIVE EDEMA
I. Congestive cardiac failure
II. Renal diseases
III. Cavernous sinus fistula
IV. Angioneurotic edema
27. Acute suppurative inflammation of gland of
zeis.
CAUSE:
Staphlococcal infection
Associated with boils,carbuncles or acne over
face.
Common in young and debilitated persons.
Poor hygiene
Diabetic patients
28. SYMPTOMS : acute throbbing pain, sense of
heaviness on lid or swelling
SIGNS : redness on affected lid
Marked edema on lid
Marked tenderness
White pus visible
Chemosis on bulbar conjunctiva
Enlargement of pre auricular lymph nodes
Sometimes multiple styes are present
29. Maintain lid hygiene
Hot fomentation
Evacuation of pus via incision
Antibiotic eye drops or ointment
Sometimes systemic antibiotics are given
Analgesics and anti-inflammatory drugs.
30. Chronic granulomatous inflammation of the
meibomian gland characterized by localized
swelling mostly away from lid margin.
ETIOLOGY;
Chronic inflammation causes replacement of
glandular tissue to granulation tissue
containing giant cells that obstructs duct of
gland.
Common in adults
31. Symptoms : painless swelling
Sense of heaviness in eyelids
32. SITE : on lid away from lid margin
SIZE: small
COLOR: overlying tarsal conjunctiva is red
when lid is everted
CONSISTENCY: cystic or hard
TENDERNESS : absent
MOBILITY: swelling is fixed to tarsus bt
overlying skin is mobile.
33. It doesn’t project on lid margin
Projects like a dome
Painless until gets infected and then its called
as INTERNAL HORDEOLUM.
34. Resolution
Remains as it is
Bursts on conjunctival tissue with granulation
tissue protruding
Gets infected (internal hordeolum)
Calcifies
Cyst formation( tarsal or meibomian syst)
Recurrence
Meibomian carcinoma
35. SMALL AND ASYMPTOMATIC : only
observed ,resolves itself .no treatment
required
LARGE: incision and curettage
MULTIPLE: combined excision of tarsus and
conjunctiva (fascenella servat operation)
MARGINAL: puncture with a diathermy
needle
Incision and curettage through tarsal plate
38. Symptoms : acute pain in lid and heaviness
Signs : similar to stye except
Point of maximum tenderness is away from
lid margin
Pus points on tarsal conjunctiva not on root
of eyelash.
39. Hot fomentation
Topical or oral antibiotic
Drainage of pus
curettage is contraindicated in internal
hordeolum
40. SUBACUTE OR CHRONIC INFLAMMATION
OF LID MARGINS.
CAUSE :
Follows Chronic conjunctivitis due to staphlococcus in poor
hygienic conditions
Parasites
41. SQUAMOUS BLEPHARITIS:
abnormal metabolism and seborhea.
Scalp Dandruff associated
Painless ,associated with watering eyes and discomfort.
Dandruff like scales
ULCERATIVE BLEPHARITIS:
Infective condition
Sore eyes, glued eyelashes, small ulcers
42. Clinical features Squamous
blepharitis
Ulcerative
blepharitis
Scales or crusts White ,fine,dry Yellow,coarse,sticky
ulceration Absent Present
bleeding Absent Present
Loss of eyelashes Few &temporary Pernanent ,almost all
lashes are involved
course Mild Progressive
complications Occasional Usual and serious
43. Trichiasis (misdirected lashes)
Tylosis (thickened lid margins)
Madarosis( scanty lashes)
Ectropion(eversion due to scar tissue)
Epiphora
44. Local : removal of crusts and diseased lashes
(3%sodium bicarbonate solution)
Epilation of eyelashes
Antibiotic drops and ointment
general : improve general health and diet
Maintain lid hygiene ( use baby shampoo)
Treat dandruff of scalp