CHAPTER FOUR

DISEASES OF THE EYE LIDS

BY
DR.SAWSAN HUSSEIN OSMAN

CONSULTANT OPHTHALMOLOGIST
A. Hordeolum Externum (stye):
An acute staphylococcal infection of a lash follicle and its
associated gland of Zeis.
Symptoms:
Pain, redness, lid margin swelling of short duration
Signs:
Tender inflamed mass in the lid margin.
Treatment:
• Hot compression
• Topical antibiotic
• Epilation of the eyelash associated with the infected follicle.

DR. SAWSAN HUSSEIN OSMAN

 STYE

DR. SAWSAN HUSSEIN OSMAN

B. Hordeolum Internum
• acute suppurative inflammation of the Meibomian glands
• Caused by staphylococcus
Symptoms:
pain, redness, swelling within eye lid
Signs:
tender, inflamed mass within the eye lid.
Treatment:
- Hot compress
- Topical antibiotics
- Surgical drainage.

DR. SAWSAN HUSSEIN OSMAN

HORDEOLUM INTERNUM

DR. SAWSAN HUSSEIN OSMAN

C. Chalazion
- A chronic granulomatous inflammatory lesion caused by
blockage of meibomian gland and stagnation of sebaceous
secretion
Symptom:
Painless nodule within the eye lid
Sign:
Non tender, firm, nodule with in the eye lid.
Treatment:
• Hot compression
• Combined local antibiotic and steroid
• Surgical incision and curettage

DR. SAWSAN HUSSEIN OSMAN

CHALAZION

DR. SAWSAN HUSSEIN OSMAN

D.Blepharitis
Chronic inflammation of the eyelid margin
There are two main types of blepharitis
1. Ulcerative blepharitis
• Caused by Staph. aureus
• Redness of lid margins with crust and removal of the crust causes bleeding and small
ulcer around the lashes
2. Squamous blepharitis:
Is associated with seborrhea of the scalp.
• The scales are greasy with less marked redness of the lid margin
Symptoms:
• Irritation
• Burning sensation
• Itching of the lid margins
Signs:
• Eye lid margin ulceration and redness in ulcerative blepharitis
• Scales on lid margin in squamous blepharitis
Treatment
- Topical antibiotics
- Topical steroid
- Treatment of seborrhea of scalp.
DR. SAWSAN HUSSEIN OSMAN
SQUAMOUS BLEPHARITIS

DR. SAWSAN HUSSEIN OSMAN

DR. SAWSAN HUSSEIN OSMAN
E. Molluscum Contagiosum:
Skin infection caused by poxvirus .
Signs
- single or multiple, pale, waxy, umbilicated nodules. If
the nodule is located on the lid margin it may give rise to
ipsilateral chronic follicular conjunctivitis and superficial
keratitis.
Treatment
- By shave excision then cauterization

DR. SAWSAN HUSSEIN OSMAN

Molluscum Contagiosum

DR. SAWSAN HUSSEIN OSMAN

F. Ptosis:
•Ptosis means drooping of the upper eye lid below it is normal position, due to Levator
muscle weakness or paralyss.
•N.B. The upper lid cover 1-2 mm of the cornea.
Causes:
a.Congenital
b.Traumatic
c.Neurogenic ( 3rd nerve palsy – Horner syndrome )
d.Mayogenic ( myeasthenia gravis or muscle dysrtrophy)
e.Mechanical (increased weight of the upper lid as in chalazion)

N.B: Horner syndrome ( oculosympathetic palsy )

Ptosis , miosis , hetrochromia and unhydrosis.

Treatment
- Surgical correction

DR. SAWSAN HUSSEIN OSMAN

DR. SAWSAN HUSSEIN OSMAN
G. Ectropion
- Means eversion of eyelid (rolling out of the eye lid)
Causes:
a. Fibrosis or scaring skin of the lid
b. Senile
c. Paralytic
Clinical picture:
- Epiphora (tearing)
- Exposed conjunctiva becomes dry ,red and thick
Treatment
- Surgical correction.

DR. SAWSAN HUSSEIN OSMAN

DR. SAWSAN HUSSEIN OSMAN
H. Entropion
- Means the eyelids turn inwards then the eyelashes rub against the
cornea leading to corneal damage .
Causes:
a. Spastic entropion due to spasm of orbicularis muscle.
b. Fibrosis and scaring of the tarsal conjunctiva caused by trachoma ,
burn or trauma .
Symptoms :
c. Foreign body senstation
d. Lacrimation
e. Reflex blepharospasm
Treatment:
- Surgical correction

DR. SAWSAN HUSSEIN OSMAN

I. Trichiasis
A condition in which the eye-lashes distorted backwards and rub into the glub.
Causes:
a.Post trachoma
b.Entropion
c.Chronic ulcerative blepharitis
d.Scaring result from trauma and burns
Symptoms:
e.Foreign body sensation
f. Lacrimation
g.Reflex blepharospasm,
Signs:
Distorted lashes corneal abrasion , ulcer or even corneal opacity
Treatment:
a. Epilation of rubbing lashes
b.Electrolysis
c.Surgical correction.

DR. SAWSAN HUSSEIN OSMAN

ENTROPION WITH TRICHIASIS

DR. SAWSAN HUSSEIN OSMAN

J. Distichiasis
It is a rare disorder define as abnormal growth of
lashes from the orifices of the meibomian gland.
 

DR. SAWSAN HUSSEIN OSMAN

K. Lagophthalmos
It is a condition of incomplete closure of the palpebral
fissure when the eyelids are shut. The most common cause
is paralysis of the orbicularis muscle.

DR. SAWSAN HUSSEIN OSMAN

L. Symblepharon
It mean adhesion between the palpebral conjunctiva and the
eyeball.

DR. SAWSAN HUSSEIN OSMAN