Disorders of the Eyelids
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Novel Anterior Segment Phenotypes Resulting from Forkhead Gene Alterations: Evidence for Cross-Species Conservation of Function
Novel Anterior Segment Phenotypes Resulting from Forkhead Gene Alterations: Evidence for Cross-Species Conservation of Function Ordan J. Lehmann,1 Stephen Tuft,2 Glen Brice,3 Richard Smith,4 Åsa Blixt,5 Rachel Bell,3 Bengt Johansson,6 Tim Jordan,1 Roger A. Hitchings,2 Peng T. Khaw,2 Simon W. M. John,4 Peter Carlsson,5 and Shomi S. Bhattacharya1 PURPOSE. Mutations in murine and human versions of an ances- cause it may affect the clinical management of certain trally related gene usually result in similar phenotypes. How- glaucoma subtypes and lead to excessive treatment. The ever, interspecies differences exist, and in the case of two FOXC1 and Foxe3 data, taken together with the novel ocular forkhead transcription factor genes (FOXC1 and FOXC2), phenotypes of FOXC2 mutations, highlight the remarkable these differences include corneal or anterior segment pheno- cross-species conservation of function among forkhead genes. types, respectively. This study was undertaken to determine (Invest Ophthalmol Vis Sci. 2003;44:2627–2633) DOI:10.1167/ whether such discrepancies provide an opportunity for iden- iovs.02-0609 tifying novel human–murine ocular phenotypes. METHODS. Four pedigrees with early-onset glaucoma pheno- types secondary to segmental chromosomal duplications or ecognition that mutations in orthologous genes frequently deletions encompassing FOXC1 and 18 individuals from 9 Rcause similar phenotypes has allowed the field of compar- FOXC2 mutation pedigrees underwent detailed ocular pheno- ative genetics to contribute to the understanding of human typing. Subsequently, mice with mutations in Foxc1 or a re- disease. As the human, murine, and Drosophila PAX6 mutants lated forkhead gene, Foxe3, were assessed for features of the (aniridia, Small eye, and eyeless) demonstrate, genotypic con- human phenotypes. -
Distichiasis (Distichia)
DISTICHIASIS (DISTICHIA) What is distichiasis? Distichiasis is a common condition that affects dogs, and less commonly, cats. The normal eyelid margin is devoid of hairs. There are multiple glands (called meibomian glands) along the eyelids which produce an oily secretion. Occasionally a hair can arise from or near these glands and project out of the eyelid. This hair is called a distichium, and the plural is distichia. These hairs may or may not come in contact with the cornea. This depends on whether they are thick/stiff or fine, and in which direction they are growing (they may be directed inwards). What problems do they cause? Some distichia do not cause any problems. These are usually fine hairs, or hairs which are directed away from the cornea. Problems arise when the hairs rub on the cornea. It causes discomfort, and the animal may have a watery eye discharge and have excessive blinking. The hair can rub on the cornea and abrade it, causing a corneal ulcer. These corneal ulcers are very difficult to treat, as the hair continues to rub in the same area, preventing healing. Distichia grow in young dogs, and if they are going to cause a problem, they usually do so ion dogs of less than two years of age. However, occasionally they can become problematic in later life, particularly if the dog gets a condition called Dry Eye or keratoconjunctivitis sicca. In this condition, there is a deficiency in tears, making the eyes dry and more susceptible to the abrading effect of the distichia. How is distichiasis diagnosed? Distichia may be seen with the naked eye with very close inspection. -
Canine Red Eye Elizabeth Barfield Laminack, DVM; Kathern Myrna, DVM, MS; and Phillip Anthony Moore, DVM, Diplomate ACVO
PEER REVIEWED Clinical Approach to the CANINE RED EYE Elizabeth Barfield Laminack, DVM; Kathern Myrna, DVM, MS; and Phillip Anthony Moore, DVM, Diplomate ACVO he acute red eye is a common clinical challenge for tion of the deep episcleral vessels, and is characterized general practitioners. Redness is the hallmark of by straight and immobile episcleral vessels, which run Tocular inflammation; it is a nonspecific sign related 90° to the limbus. Episcleral injection is an external to a number of underlying diseases and degree of redness sign of intraocular disease, such as anterior uveitis and may not reflect the severity of the ocular problem. glaucoma (Figures 3 and 4). Occasionally, episcleral Proper evaluation of the red eye depends on effective injection may occur in diseases of the sclera, such as and efficient diagnosis of the underlying ocular disease in episcleritis or scleritis.1 order to save the eye’s vision and the eye itself.1,2 • Corneal Neovascularization » Superficial: Long, branching corneal vessels; may be SOURCE OF REDNESS seen with superficial ulcerative (Figure 5) or nonul- The conjunctiva has small, fine, tortuous and movable vessels cerative keratitis (Figure 6) that help distinguish conjunctival inflammation from deeper » Focal deep: Straight, nonbranching corneal vessels; inflammation (see Ocular Redness algorithm, page 16). indicates a deep corneal keratitis • Conjunctival hyperemia presents with redness and » 360° deep: Corneal vessels in a 360° pattern around congestion of the conjunctival blood vessels, making the limbus; should arouse concern that glaucoma or them appear more prominent, and is associated with uveitis (Figure 4) is present1,2 extraocular disease, such as conjunctivitis (Figure 1). -
Lid and Lash Conditions
Perth Veterinary Ophthalmology Lid and Lash Conditions Eyelid Diseases The most common eyelid diseases are entropion, ectropion and facial droop. Entropion Entropion means a turning in of the lids. This is a common complaint in young dogs but can sometimes affect older dogs and cats as well. Most cases in young dogs affect the lower lids, but the upper lid can become affected in later life in some breeds such as Cocker Spaniels and Bloodhounds. Entropion Some breeds such as Shar Peis, Chows, Rottweillers and Mastiffs can have very complex entropion leading to defects in both upper and lower lids. A Shar Pei with severe upper and lower lid entropion Entropion is painful and can be potentially blinding. The rolling in of the lid leads to hair coming into contact with the cornea, leading to pain, ulceration and scarring (which can affect vision). In severe cases this can even lead to perforation of the eye. There are many causes of entropion. It can be primary or secondary to other problems affecting the lids (such as ectopic cilia, distichiasis etc. - see below). Some possible causes include the lid being too long, the lid being too tight, instability of the lateral canthus (outer cornea of the eyelids), misdirection of the lateral canthal tendon, brachycephalic anatomy (big eyes and short nose - e.g. Pekingese, Pugs, Shih Tsus, Persian cats etc.), diamond eye defects, loose or too much skin, facial droop etc. Often these cases are referred to a veterinary ophthalmologist for proper assessment and treatment to provide the best outcome. Entropion requires surgical correction. -
Eleventh Edition
SUPPLEMENT TO April 15, 2009 A JOBSON PUBLICATION www.revoptom.com Eleventh Edition Joseph W. Sowka, O.D., FAAO, Dipl. Andrew S. Gurwood, O.D., FAAO, Dipl. Alan G. Kabat, O.D., FAAO Supported by an unrestricted grant from Alcon, Inc. 001_ro0409_handbook 4/2/09 9:42 AM Page 4 TABLE OF CONTENTS Eyelids & Adnexa Conjunctiva & Sclera Cornea Uvea & Glaucoma Viitreous & Retiina Neuro-Ophthalmic Disease Oculosystemic Disease EYELIDS & ADNEXA VITREOUS & RETINA Blow-Out Fracture................................................ 6 Asteroid Hyalosis ................................................33 Acquired Ptosis ................................................... 7 Retinal Arterial Macroaneurysm............................34 Acquired Entropion ............................................. 9 Retinal Emboli.....................................................36 Verruca & Papilloma............................................11 Hypertensive Retinopathy.....................................37 Idiopathic Juxtafoveal Retinal Telangiectasia...........39 CONJUNCTIVA & SCLERA Ocular Ischemic Syndrome...................................40 Scleral Melt ........................................................13 Retinal Artery Occlusion ......................................42 Giant Papillary Conjunctivitis................................14 Conjunctival Lymphoma .......................................15 NEURO-OPHTHALMIC DISEASE Blue Sclera .........................................................17 Dorsal Midbrain Syndrome ..................................45 -
Lid Splitting and Posterior Lamellar Cryotherapy for Congenital Distichiasis and Trichiasis in Dog
Scientific Works. Series C. Veterinary Medicine. Vol. LXI (1) ISSN 2065-1295; ISSN 2343-9394 (CD-ROM); ISSN 2067-3663 (Online); ISSN-L 2065-1295 LID SPLITTING AND POSTERIOR LAMELLAR CRYOTHERAPY FOR CONGENITAL DISTICHIASIS AND TRICHIASIS IN DOG 1Andra ENACHE, 2Pip BOYDELL, 1Iuliana IONAŞCU, 1Alexandru ŞONEA 1University of Agronomical Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Bucharest, Romania, [email protected] 2 Animal Medical Centre Referral Services, Manchester, United Kingdom Corresponding author email: [email protected] Abstract Various surgical techniques have been proposed for treating distichiasis in dogs. A technique involving eyelid splitting and double freeze-thaw cryotherapy with anterior lamellar recession was evaluated. A 3 year old, female, Staffordshire bull terrier was referred for bilateral distichiasis. There were bilateral multiple distichiasis of the upper lids, more severe on the right lid with double row of cilia and two cilia on the lower lid. Under general anaesthesia, the eyelid margin was split at the gray line and a cryoprobe was used to freeze the posterior lamella. A double freeze-thaw technique was applied in both eyes. Anterior lamellar recession was performed to prevent postoperative entropion with trichiasis. The anterior and posterior lamellas were sutured with a 6/0 Vicryl suture. Bilateral upper eyelid edema was noted postoperatively. A month follow-up revealed increased bilateral granulation and depigmentation and the recurrence of one follicle on the right upper lid. Five months postoperatively there was no recurrence in the left eye but three cilia were detected in the right upper lid. The follicles have regrown due to incomplete destruction of the roots. -
The Management of Congenital Malpositions of Eyelids, Eyes and Orbits
Eye (\988) 2, 207-219 The Management of Congenital Malpositions of Eyelids, Eyes and Orbits S. MORAX AND T. HURBLl Paris Summary Congenital malformations of the eye and its adnexa which are multiple and varied can affect the whole eyeball or any part of it, as well as the orbit, eyelids, lacrimal ducts, extra-ocular muscles and conjunctiva. A classification of these malformations is presented together with the general principles of treatment, age of operating and surgical tactics. The authors give some examples of the anatomo-clinical forms, eyelid malpositions such as entropion, ectropion, ptosis, levator eyelid retraction, medial canthus malposition, congenital eyelid colobomas, and congenital orbital abnormalities (Craniofacial stenosis, orbi tal plagiocephalies, hypertelorism, anophthalmos, microphthalmos and cryptophthalmos) . Congenital malformations of the eye and its as echography, CT-scan and NMR, enzymatic adnexa are multiple and varied. They can work-up or genetic studies (Table I). affect the whole eyeball or any part of it, as Surgical treatment when feasible will well as the orbit, eyelids, lacrimal ducts extra encounter numerous problems; age will play a ocular muscles and conjunctiva. role, choice of a surgical protocol directly From the anatomical point of view, the fol related to the existing complaints, and coop lowing can be considered. eration between several surgical teams Position abnormalities (malpositions) of (ophthalmologic, plastic, cranio-maxillo-fac one or more elements and formation abnor ial and neurosurgical), the ideal being to treat malities (malformations) of the same organs. Some of these abnormalities are limited to Table I The manag ement of cong enital rna/positions one organ and can be subjected to a relatively of eyelid s, eyes and orbits simple and well recognised surgical treat Ocular Findings: ment. -
International Classification of Diseases
INTERNATIONAL CLASSIFICATION OF DISEASES MANUAL OF THE INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES, INJURIES, AND CAUSES OF DEATH Based on the Recommendations of the Eighth Revision Conference, 1965, and Adopted by the Nineteenth World Health Assembly Volume 2 ALPHABETICAL INDEX WORLD HEALTH ORGANIZATION GENEVA 1969 Volume 1 Introduction List of Three-digit Categories Tabular List of Inclusions and Four-digit Sub- categories Medical Certification and Rules for Classification Special Lists for Tabulation Definitions and Recommendations Regulations Volume 2 Alphabetical Index PRINTED IN ENGLAND CONTENTS Introduction Page General arrangement of the Index ....................................... VIII Main sections ............................................................... VIII Structure ..................................................................... IX Code numbzrs .............................................................. x Primary and secondary conditions. ................................... x Multiple diagnoses. ........................................................ XI Spelling....................................................................... XI Order of listing ............................................................. Conventions used in the Index ........................................... XII Parentheses. ................................................................. XII Cross-referexes ........................................................... XI1 Abbreviation NEC. ...................................................... -
The 25Th Annual Waltham/OSU Symposium Small Animal Ophthalmology October 27—28, 2001
The 25th Annual Waltham/OSU Symposium Small Animal Ophthalmology October 27—28, 2001 Conditions of the Eyelids and Ocular Adnexa in Dogs and Cats ________________________________________ David T. Ramsey, DVM, Diplomate ACVO Associate Professor, Comparative Ophthalmology, Department of Small Animal Clinical Sciences D-208 Veterinary Medical Center Michigan State University East Lansing, MI 48824-1314 ________________________________________ The eyelids and ocular adnexa comprise the primary surface defense for the globe, specifically the cornea. Physical or functional abnormalities of the lids or adnexal ocular structures may result in abnormalities of the cornea and subsequently vision. This commentary will discuss diagnosis and treatment of the more common abnormalities affecting the lids and ocular adnexa in dogs and cats. Anatomy The eyelids represent a composite structure composed of skin and cutaneous appendages, including hair follicles and glandular structures. Dogs have eyelashes only on the upper lid and cats lack upper and lower eyelashes. The palpebral conjunctiva is a highly vascular mucous membrane that lines the inner aspect of the lids. Interposed between the surface skin and palpebral conjunctiva is skeletal muscle and fibrous tissue. Eyelids are highly vascularized, therefore they are fairly resistant to microbial infection and have the property of healing rapidly after suffering trauma, but may enlarge considerably from transvascular exudation of fluid into lid tissue when irritated. Since skin comprises a substantial portion of the eyelid, a plethora of dermatologic conditions may affect the eyelids.1 The adnexa consists of all segments of conjunctiva (palpebral, nictitans, bulbar and fornix), and the nictitating membrane. The conjunctiva is the most exposed mucous membrane of the body. -
Entropion, Ectropion and Ptosis Surgery
Patient Information Entropion, Ectropion and Ptosis Surgery ENTROPION is a lid condition in which the eyelid BEFORE YOUR OPERATION becomes lax and turns inwards. This causes the eyelashes to rub and irritate the eye making it red, uncomfortable and watery. The lower lid can Do I take my normal medication? be pulled back into the right position temporarily with a piece of tape placed between the lower Please stop aspirin 1 week prior to surgery lid and your cheek. An operation is needed to with permission from your GP. If you take any correct this condition permanently. medication to thin your blood e.g. warfarin as prescribed medication, please contact your GP ECTROPION is a lid condition in which the eyelid two weeks before your operation for further becomes lax and turns outwards. This may make instructions - telephone 01392 406013. the eyes water. This is treated by an operation to Otherwise take your normal medication and tighten the eyelid. bring them into hospital with you. There is a small risk that the conditions above may reoccur and require more than one Can I eat and drink normally? operation. There is also a small risk of bleeding and infection. Yes. Please have breakfast before morning surgery and a light lunch before afternoon PTOSIS (pronounced ‘Toesis’) in adults is a surgery. condition where the upper eyelid stretches and begins to droop. This can look unsightly and in Do I need to wear anything special? severe cases can affect the eyesight. It is treated Yes. Wear comfortable loose fitting clothes by an operation which tightens the muscle that as you may be asked to change into a theatre opens your upper eyelid. -
Surgery Prioritization Strategy: Codes for Typical Ophthalmic Procedures
Surgery Prioritization Strategy: Codes for Typical Ophthalmic Procedures Emergent Condition/Service CPT code(s) Endophthalmitis 67015 Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) 65800 Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous 67028 Intravitreal injection of a pharmacologic agent (separate procedure) Note: 67028 is bundled with both 67015 and 65800 Open globe, disruption of operative 65275 Repair of laceration; cornea, nonperforating, with or without removal foreign body incision 65280 Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue 65285 Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue 65286 Repair of laceration; application of tissue glue, wounds of cornea and/or sclera 66250 Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure Cantholysis/canthotomy 67715 Canthotomy (separate procedure) Intraocular foreign body 65235 Removal of foreign body, intraocular; from anterior chamber of eye or lens 65260 Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route 65265 Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction 67413 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body Canalicular lacerations 68700 Plastic repair of canaliculi 67950 Canthoplasty (reconstruction -
10867 Ocular Vol 9 #1.Indd
Volume 9, Issue 1 October 2010 ® A Quarterly Publication for the Veterinary Community from Eye Care for Animals When Hairs Meet the Eye become shortened the facial skin has sequestra. In some dogs we see corneal not correspondingly been reduced - this vascularization and medial corneal results in the formation of large nasal pigmentation as a result of the chronic folds of haired skin. Hair on the nasal cilia irritation. This pathology is often folds may impinge on the eye and cause compounded by the abnormally large problems in some dogs. As the facial palpebral fissure (macroblepharon), the skin is pushed towards the eye there is shallow orbit which limits the extent to a tendency for the lower eyelid to roll which the eye can be retracted and the against the eye (entropion). This is lids closed over the cornea, the extreme usually compounded by tight attachment rounded (rather than elliptical) shape of the medial canthus (the location where of the upper and lower eyelids around the upper and lower eyelids join on the the medial canthus which may reduce nasal side of the face) to the underlying the effective medial corneal coverage bone via the medial palpebral ligament. during blinking, and in some dogs Nicholas J. Millichamp, The net result is a rolling of the medial reduced tear secretion from the lacrimal BVetMed, PhD, DVOphthal, DECVO, part of the lower (and occasionally glands (keratoconjunctivitis sicca). All MRCVS, DACVO upper) eyelid such that normal eyelid of these factors (and probably some that Eye Care for Animals cilia contact the conjunctiva or cornea.