Ophthalmology Orbit, Globe, Plastics, Lids, Lashes, Lacrimation

Front 1

Trichiasis

Back 1

misdirected lashes

Front 2

Distichiasis

Back 2

extra row of lashes

Front 3

Ankyloblepharon

Back 3

fusion of all or part of lids

Front 4

Cryptophthalmos

Back 4

failure of lids to develop or separate; often eye is malformed

Front 5

Entropion

Back 5

1) horizontal lid laxity=lateral tarsal strip; 2) involutional (lower retractor dehiscence)=retractor advance (suture retractors to tarsus); 3) overriding of pretarsal orbicularis by preseptal orbicularis= excision of strip of preseptal orbicularis; 4) ciccatrization

Front 6

Ectropion

Back 6

involutional (increased laxity of lid (aging + gravity)) > paralytic (bells palsy), mechanical (tumor, edema) & cicatricial (shortening of anterior lamella (scaring, burns, solar, inflammation) >>> congenital

Front 7

Epicanthus

Back 7

palpebralis
inversus
tarsalis
supraciliaris

Front 8

Epicanthus
palpebralis

Back 8

(simple) broader above

Front 9

Epicanthus
inversus

Back 9

broader below

Front 10

Epicanthus
tarsalis

Back 10

equally broad above & below

Front 11

epicanthus
supraciliaris

Back 11

origin from eyebrow

Front 12

Epiblepharon

Back 12

asian kids; altered lower lid retractor attachments-->overriding of pretarsal orbicularis

Front 13

Levator dehiscence

Back 13

high lid crease (“involutional ptosis”)

Front 14

Euryblepharon

Back 14

horizontal widening of lid fissure

Front 15

Lower lid retractor disinsertion

Back 15

white line inf to tarsal border; higher than normal lower lid position; decreased movement on lower lid on down gaze; elongation of inferior fornix

Front 16

lid colobomas

Back 16

do not come from failure of embryonic fissure closure; upper lid>lower; if medial upper, typically isolated finding; lower lid=more often assoc w/ cong anomalies (clefting); assoc w/ Goldenhar’s

Front 17

Blepharophimosis syndrome

Back 17

AD; small horizontal fissure; congenital; assoc w/ Tetrad: 1)telecanthus, 2)blepharoptosis, 3)blepharophimosis, 4)epicanthus inversus; may also have lower lid ectropion, poor development of orbital rims & nasal bones, ??hypertelorism

Front 18

Dacryoliths

Back 18

palpable masses in lacrimal sac

Front 19

Dacryocystocele

Back 19

blocked valve of Hasner

Front 20

Congenital lacrimal fistula

Back 20

abnormality in surface ectoderm; assoc w/ tear reflux & NLDO

Front 21

Canalicular stenosis causes:

Back 21

infectious (herpetic, trachoma, mono), inflammatory (SJS, OCP), trauma (lac, chemical/thermal injury, repeated probing), allergy, radiation, tumors, canaliculitis, eye drops (antivirals, strong miotics, epinephrine)

Front 22

Orb floor fxr

Back 22

most often within the maxilla, posterior & medial to the infraorbital canal (thickness is only ~0.5mm);

Front 23

Steatoblepharon

Back 23

orbital fat bulging

Front 24

Xanthelasma

Back 24

histo=foamy histiocytes; typically no hyperlipidemia (~25% are); lesions in dermis

Front 25

Dacryadenitis

Back 25

acute painful enlargement: bacterial
chronic, painless, bilateral enlargement: sarcoid>lymphoma, syphilis, TB

Front 26

Mikolicz’s

Back 26

chronic dacryoadenitis + Sjogrens

Front 27

Dacryocystitis

Back 27

chronic, asymptomatic=Strep pneumo

Front 28

Nanophthalmos

Back 28

ant sclerotomy may be indicated ig pre-op AC is shallow & choroid is thickened; complications: RD, choroidal effusion & seroud RD, post-op angle closure, flat AC, cystoid macular edema, corneal decomp, malignant glaucoma; surg of choice=extracap w/ PC IOL through smallest incision possible

Front 29

microphthalmos

Back 29

Associated with fetal alcohol syndrome, congenital infections (HSV, CMV, rubella), (trisomy 13 (Patau syndrome), Triploid Syndrome, and Wolf-Hirschhorn Syndrome); axial length <21 mm in an adult, or <19 mm in a one-year-old

Front 30

Hypertelorism

Back 30

abnormally wide distance btwn eyes (measure from medial walls)

Front 31

Telecanthus

Back 31

wide space between eyes (measured from medial canthi)—may be secondary to hypertelorism or isolated finding

Front 32

orbital pseudotumor:
Adults

Back 32

More likely to involve lacrimal gland

Front 33

orbital pseudotumor:
Kids

Back 33

1/3 bilateral; rarely associated w/ systemic diseased.
More systemic features: headache, fever, vomiting, lethargy
CBC=peripheral eosinophilia

Front 34

Thyroid orbitopathy

Back 34

surgical tx=decompress --> strab --> lids; CT=no tendon involvement; most commonly involved=inferior rectus & medial rectus

Front 35

Craniosynostosis

Back 35

midfacial hypoplasia, V-pattern exotropia, proptosis, telecanthus

Front 36

Pfeiffers

Back 36

Craniosynostosis
AD, shallow orbits, syndactyly, short digits (thumbs/big toes), underdeveloped mid-face

Front 37

Crouzons

Back 37

craniofacial synostosis; premature closure of sutures, midface hypoplasia and shallow orbits, proptosis, maxillary hypoplasia, hypertelorism, beaked nose, short stature, abnormalities of the spine, a large protruding lower jaw, misalignment of teeth, and high-arched, narrow or cleft palate, strabismus, progressive optic nerve atrophy in cases of associated intracranial hypertension

Front 38

Aperts

Back 38

craniofacial synostosis; premature closure of sutures
craniofacial synostosis; premature closure of sutures, syndactyly, sunken midface w/ shallow orbits, proptosis, strabismus,maxillary hypoplasia w/ protruding lower jaw, cardiac anomalies, gastrointestinal malformations, cleft palate, hearing deficits due to recurrent ear infections, acne. (more craniofacial problems, but less proptosis than crouzons) (30% mental retardation)

Front 39

Plagiocephaly

Back 39

positional flattening of skull

Front 40

Treacher Collins

Back 40

Craniosynostosis
clefting syndrome; hypoplasia of mid face, pseudocolobomas of lids (lower lid coloboma), downward angle to lateral canthi (antimongoloid slant), dental & ear anomalies