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THE EYELIDS and the eyelid margin,[object Object],Dr. Anupama Karanth,[object Object],www.ophthalclass.blogspot.com,[object Object]
Anatomy,[object Object],What does it have?,[object Object]
Anatomy,[object Object],In simpler terms,[object Object],Anterior lamella,[object Object],skin and orbicularis,[object Object],Posterior lamella,[object Object],tarsus and conjunctiva,[object Object]
Development,[object Object],The story begins very early…,[object Object],Two folds of  ectoderm and mesoderm appear at 8 weeks,[object Object]
Development,[object Object],…and fuse by the tenth week,[object Object]
Development,[object Object],They separate again in the ,[object Object],seventh month,[object Object]
Congenital anomalies,[object Object]
Congenital anomalies,[object Object],Blepharophimosis syndrome,[object Object],Ptosis,[object Object],Epicanthusinversus,[object Object],Horizontally shortened palpebral aperture,[object Object]
Congenital anomalies,[object Object]
The eyelid margin,[object Object],Posterior edge,[object Object],		sharp,[object Object],mucocutaneous junction,[object Object],Meibomian orifices,[object Object],Gray  line ( muscle of Riolan),[object Object],Lash line ,[object Object],Anterior edge,[object Object]
Eyelid inflammation,[object Object]
Eyelid inflammation,[object Object]
Anterior blepharitis,[object Object]
Clinical features of anterior blepharitis,[object Object]
Ulcerative blepharitis,[object Object]
Squamousblepharitis,[object Object]
Management of anterior blepharitis,[object Object],Lid hygiene,[object Object],Warm compresses,[object Object],Mechanical removal of crusts and scales by scrubbing,[object Object],Baby shampoo as scrubbing solution,[object Object],Application of antibiotic eye ointment (Staphylococcal),[object Object],Anti-dandruff shampoo for scalp (Squamous),[object Object]
Posterior blepharitisMeibomian gland disease/meibomianitis,[object Object],Symptoms,[object Object],Nonspecific, burning, itching, redness,[object Object],Associated condition,[object Object],Acne rosacea,[object Object],Complications,[object Object],Secondary dry eyes,[object Object],Epithelial keratitis,[object Object],Recurrent styes / chalazia,[object Object],Papillary conjunctivitis,[object Object]
Clinical features of posterior blepharitis,[object Object],Meibomian orifices,[object Object],Pouting, obstructed, oily globules,[object Object],Telangiectasia around orifices,[object Object],Digital pressure on lid margin,[object Object],Hyposecretion ,[object Object],Hypersecretion – foamy, turbid or tooth paste like secretion,[object Object]
Meibomian gland disease,[object Object],Foamy secretion,[object Object],Blocked meibomian orifices,[object Object]
Management of posterior blepharitis,[object Object],Warm compresses,[object Object],Lid massage to express oily secretion,[object Object],Short term antibiotic – steroid eye ointment, ocular lubricants,[object Object],In severe cases and in acne rosacea – oral tetracycline / doxycycline for at least 6-8 weeks,[object Object]
Eyelid gland inflammations,[object Object],Acute inflammation (stye),[object Object],Staphylococcal infection,[object Object],Glands of Zeiss / Moll (associated with hair follicles) – Hordeolumexternum,[object Object],Meibomian glands – Hordeoluminternum,[object Object],Acute, painful and tender nodular swellings of the lid,[object Object]
Hordeolum,[object Object],Hordeoluminternum,[object Object],Hordeolumexternum,[object Object]
Acute infection (Staphylococcal abscess),[object Object],Internal hordeolumExternal hordeolum,[object Object],Meibomian gland,[object Object],Tarsal plate,[object Object],Zeis or Moll glands,[object Object],Lid margin,[object Object]
Multiple styes,[object Object]
Hordeolum,[object Object],Management of hordeolum,[object Object],Mainstay of therapy – hot compreses,[object Object],If pus pointing present at eyelash base – remove eyelash,[object Object],If pus pointing at the skin or conjunctiva – drain pus,[object Object],If associated with blepharitis – treat blepharitis,[object Object]
Hordeoluminternum,[object Object],Pointing on the skin,[object Object]
Internal hordeolum,[object Object],Pointing on the conjunctival side,[object Object]
Eyelid gland inflammations,[object Object],Chronic inflammation of meibomian gland – Chalazion,[object Object],Meibomian cyst,[object Object],Chronic,[object Object],Sterile,[object Object],Granulomatous inflammation,[object Object],Blocked meibomian gland orifice,[object Object],Painless, non-tender nodular swelling of the eyelid,[object Object]
Chalazion,[object Object],Chalazion breaking through the conjunctiva,[object Object],1A,[object Object],1B,[object Object]
Recurrent chalazia,[object Object]
Management of chalazion,[object Object]
Incision and curettage,[object Object]
Local anesthesia,[object Object]
Chalazion clamp,[object Object]
Incision,[object Object]
Curettage,[object Object]
Clamp removed,[object Object]
The eyelid infections,[object Object],Molluscumcontagiosum,[object Object]
The eyelid infections,[object Object],Herpes zoster ophthalmicus,[object Object]
Eyelash disorders,[object Object],Trichiasis,[object Object],Inturned eyelash,[object Object],Poliosis,[object Object],White colored lashes,[object Object],Madarosis,[object Object],Loss of lashes,[object Object],Distichiasis,[object Object],Lashes from meibomian orifices,[object Object]
Trichiasis,[object Object]
Poliosis,[object Object]
Distichiasis,[object Object]

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