1. Disorders of malposition of the lids
Ayesha S Abdullah

2. Recap
CATARACT

3. Glaucoma

4. Corneal opacity

5. Childhood blindness mortality & morbidity
Vitamin A deficiency
Normal
Corneal xerosis
Keratomalacia
Bitot spot

6. Trachoma

8. Age-related macular degeneration

9. DIABETIC RETINOPATHY

10. What abnormality do you see?

14. 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

15. Disorders of malposition of the lids
Ectropion
Entropion
Ptosis
Lagophthalmos
Trichiasis (disorder of eyelashes)

16. What are the factors responsible for the normal positioning of the eyelids ?

18. What are the factors responsible for the normal positioning of the eyelids ?
Tarsal plate
Orbicularis oculi
Lid retractors
Medial and lateral canthal tendons

23. 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

24. Ectropion
Definition
Outward rolling of the lid margin is called ectropion
Types
Congenital
Acquired
Involutional
Cicatrical
Paralytic
Mechanical

25. INVOL.
CICATRICAL
PARALYTIC
MECHANICAL

26. Ectropion
Complications
Conjunctival
Corneal

28. Ectropion Management Medical Surgical
Lubricants; artificial tears and lubricating ointments
A protective eye shield worn at night to prevent drying
Temporary taping of the lid
Surgical

29. Entropion Definition Types Congenital Acquired
Inward rolling of the eyelid margin
What is inward turning of the eyelashes called?
Types
Congenital
Acquired
Involutional
Cicatrical
Spastic

30. Complications Management Conjunctival Corneal Medical Surgical
Lubricants; artificial tears and lubricating ointments
A protective eye shield worn at night to prevent drying
Surgical

32. Ptosis No MAM Definition Drooping of the upper eyelid Types:
Congenital
Acquired
Neurogenic
Myogenic
Aponeurorotic
Mechanical No
MAM

33. Ptosis Clinical evaluation Amount of ptosis
Function of Levator Palpebrae Superioris
Bell’s phenomenon

34. Complications
Amblyopia in children
Treatment
Surgical

35. Diagnosis
Complication ?

36. Photo Quiz

39. Jaw Winking