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35 Cards in this Set
- Front
- Back
define ptosis
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An abnormally low position (drooping) of the upper eyelid
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ptosis is also called
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blepharoptosis
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types fo ptosis
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Congenital
Acquired |
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90% of ptosis cases are congenital or acquired
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Congenital, and present at birth, and 70% are unilateral
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causes of congenital ptosis
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irregularity of the levator muscle (mygenic) or abnormalities of the CN 3 superior division (neurogenic).
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objective signs for ptosis?
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one lid lower., lid in down gaxe will be higher for congenital and equal to the other when it is acquired.
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what is marcus gunn syndrome?
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anomalous innervation. Aptotic lid elevates with mastication or jaw movement to the opposite side.
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types of aquired ptosis are?
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neurogenic, myogenic, aponeurotic (structural change in aponeurosis), and mechanical.
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An example of acquired neurogenic ptosis?
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Horners syndrome. ptosis miosis and anhidrosis. lack of sympathetic innervation. DM or aneurysms of the IC artery.
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if a pt presents with motor problems what are the signs?
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cranial nerve 3 problems. defective adduction, depression, and elevation.
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what is an example of acquired myogenic ptosis? and what are the signs?
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Myasthenia gravis. basically a muscle problem. bilateral ptosis. the Pt may have a history of fluctuating ptosis and strabismus.
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what is the most common type of aquired ptosis and is it unilateral or bi?
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Aponeurotic ptosis and it is usually bilateral.
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Acquired mechanical ptosis is caused by what?
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excessive weight, like edema tumors or traumatic events such as lacerations effecting nerves or muscles.
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what are some examples of pseudoptosis?
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other eye is bulging, a prosthetic eye is in place, or dermatochalasis.
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what are the values of mild, moderate and severe ptosis in mm.
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Mild: 1-2mm
Moderate: 2-3mm Severe: ≥4mm |
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Other than amblyopia what could a ptotic eye cause in regaurds to vision?
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astigmatism from the compression.
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what is the proper way to evaluate the palpebral fissure on a ptotic pt?
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use a pd ruler. have them look down and then while holding the frontalis muscle have them look up.
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if the movement of the upper lid is equal in the up and down gaze is the levator good or bad in a ptotic Pt.
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Good.
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If the movement of the upper lid is greater up than down what is typically the problem in a ptotic pt?
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typically dystrophic muscle.
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what should the total lid elevation be as the pt looks from down gaze to up gaze?
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8-14 mm
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with a ptotic pt if you want to watch for amblyopia how often should you schedule a follow up?
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3-4 months also look for signs of a head turn.
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average number of blinks per minute?
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15-20
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what is blepharoclonus?
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increased frequency of blinking, increased closure phase (while lid is closed), caused by irritation and inflammation.
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what population is blepharoclonus usually seen in?
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children
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what is myokymia? what is it caused by?
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lid twitch, fasciculation of the orbicularis. stress, tension, lack of sleep, caffeine...
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treatment for myokymia?
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remove the cause, inject botox, use antihistamines, or quinine (tonic water)
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define blepharospasm
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Any abnormal tic or twitch of the eyelid bilateral involuntary orbicularis contraction resulting in lid closure. spasmodic, idiopathic.
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typical pt that has blepharospasms?
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>50, F>M,
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Blepharospasm commonly is associated with
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dystonic movements of other facial muscles
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subjective: changes with long standing blepharospasms include?
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eyelid and brow ptosis
Dermatochalasis Entropion canthal tendon abnormalities |
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Early symptoms of blepharospasm include
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increased blink rate, eyelid spasms, eye irritation, midfacial or lower facial spasm, brow spasm and eylid tic.
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Conditions relieving blepharospasm included
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sleep, relaxation, interior gaze, artificial tears, singing, humming.
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Differential Diagnoses of blepharospasms
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FB, trichiasis, kaeratitis,, meiges syndrome, FACIAL AND EYELID MYOKYMIA, hemifacial spasms, facial tic.
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therapy for blepharospasms
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reassurance, botox and it would need to be re injected in 3-4 months. last choice would be therapy. it involves removal of the orbicularis.
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what is the difference b/t a nodule and a tumor
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size. nodule us 5-20 mm
a tumor is >20mm |