Lids & Lashes
Baby picture of the day!
Trichiasis Inward-turned eyelashes
Madarosis Missing eyelashes
Dermatochalasis Weakened orbital septum causes sagging eyelid skin Ptosis/pseudoptosis Superior visual field loss
Blepharitis Staph blepharitis – discharge, morning crusting Seborrheic blepharitis – eyelash flakes
Hordeolum Acute staph infection of glands Tender Internal – meibomian glands External – Zeis/Moll glands (“stye”)
Chalazion Chronic sterile inflammation of meibomian gland Hard Painless Recurrent: think sebaceous gland carcinoma
Ectropion / Entropion Eyelid oriented away from globe Concerns: exposure keratopathy, epiphora Eyelid oriented toward the globe Concerns: trichiasis
Floppy Eyelid Syndrome Lid eversion during sleep Associated with sleep apnea in obese men Morning redness & SPK
Benign Essential Blepharospasm (BEB) Bilateral involuntary closure of eyes Orbicularis oculi, procerus, AND corrugator Idiopathic
Myokymia Involuntary unilateral twiching of eyelids Orbicularis oculi only Causes: sleep deprivation, caffeine, stress
Malignant Eyelid Tumors Basal Cell Carcinoma (BCC) Squamous Cell Carcinoma (SCC) Sebaceous gland carcinoma Malignant melanoma
Basal Cell Carcinoma (BCC) #1 eyelid cancer Malignancy of basal cell layer of epidermis Risk factor: sun Pearly nodule, telangiectasia “Rodent ulcer”
Squamous Cell Carcinoma (SCC) #2 eyelid cancer More dangerous than BCC Associated with actinic keratosis (elevated, red, scaly lesion)
Sebaceous Gland Carcinoma Neoplasm of sebaceous glands (meibomian & Zeis) Associated with recurrent chalazia Madarosis
Malignant Melanoma Most lethal primary skin cancer Malignancy of melanocytes
Signs of Malignancy ABCDE: Asymmetry Border irregularity Color differences Large diameter Enlargement