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Eyelid Pathology 1
Eyelid Pathology 1
Sachitanand Singh
Anatomy of
upper eye
lid
Lid
margin
Keratin or horny layer
(stratum corneum)
•Blood vessels
•Lymphatics
•Nerves
•Fibroblasts
•Macrophages
•Mast cells
Adenxal
glands
Sebaceous glands
They are located in the caruncle and within eyebrow hairs.
Meibomian glands
They are modified sebaceous glands found in the
tarsal
plates.
They empty through a single row of 20 - 30 orifices on each
lid.
A gland consists of a central duct with multiple acini, the
cells of which synthesize lipids (meibum) that form the
outer layer of the tear film.
Adenxal
glands
Glands of Zeis
They are modified glands associated with lash
sebaceous follicles.
Glands of Moll
They are modified apocrine sweat glands opening either into a
lash follicle or directly onto the anterior lid margin between
lashes; they are more numerous in the lower lid.
Crust
Terminology
(Clinical)
Cyst. A nodule consisting of an epithelial-lined
cavity
filled with fluid or semi-solid material.
Plaque. A solid elevation of the skin, ( > 1 cm)
in
diameter.
Scale. Readily detached fragments of shed keratin layer.
Papilloma. A benign neoplastic warty or tag-
like projection of the skin or mucous membrane.
Ulcer. A circumscribed area of epithelial loss; in skin an
ulcer extends through the epidermis into the dermis.
Scale
Papilloma Ulcer
Classification of Eyelid
Disorders
Congenital
Inflammatory
Neoplastic
Degenerative; involutional
Vascular
Traumatic
1- Congenital anomalies of the
eye lid
Isolated
Associated with other eyelid, facial
or systemic anomalies
Congenital
Ankyloblepharon Epicanthus Epiblepharon
entropion
Congenial Congenital
coloboma distichiasis
1- Congenital anomalies of the
eye lid
Euroblepharon Ankyloblepharon
Epicanthus Epiblepharon
1- Congenital anomalies of the eye
lidCongenital entropion
Congenital ptosis
Congenital ectropion
Congenial coloboma
1- Congenital anomalies of the
eye lid
Blepharophimosis
syndrome
Inheritance: AD
Clinical features:
○ Telecanthus.
Additional findings:
○lateral lower eyelid ectropion secondary to vertical
lid
deficiency.
○ A poorly developed nasal bridge.
○ Hypoplasia of the superior orbital rims.
1- Congenital anomalies of the
eye lid
Congenital distichiasis
1- Congenital anomalies of the
eye lid
Partial or complete absence of the
eyebrow, palpebral fissure, eyelashes, and
conjunctiva.
Unilateral or bilateral.
Causative organism:
Moraxella lacunata or
S. aureus
C/p: Red, scaly, macerated
and fissured skin is seen at
the lateral and/or medial
canthi of one or both eyes).
Anterior
blepharitis
4. Parasitic infestation
Demodex infestation
Pubic louce (Phthiriasis palpebrarum)
Posterior
blepharitis
Meibomian gland
dysfunction
Corynbacterium
acne ---
lipase ---Free FAs---
increase
melting point of meibum---
prevents expression of it---
Irritation/Tear film instability
due to loss of its ph lipids
Characteristic of chronic
blepharitisFeature Staph Seborrheic posterior
PFs
Painful swelling
○ Diffuse stage
○ Localized stage
Localized lid margin
inflammations
Chalazion
Chronic
lipogranulomatous
inflammation of
Meibomian gland.
Painless swelling
PFs
Complications
DD
Empty space contained fat dissolved
out during processing
Chronic
inflammatory cells
Other eye lid
cysts
Cyst of Zeis is a small, non-translucent cyst on the
anterior lid margin arising from obstructed sebaceous
glands associated with the eyelash follicle.
Other eye lid
cysts
Cyst of Moll
(apocrine hidrocystoma) is a small retention cyst of the
lid margin apocrine glands. It appears as a round, non-
tender, translucent fluid-filled lesion on the anterior lid
margin.
Other eye lid
cysts
Sebaceous (pilar) cyst is
caused a blocked
pilosebaceous follicle and
by
contains
sebaceous secretions; the
gland orifice will often be
visible. It is only rarely found
on the eyelid although it may
occasionally occur at the
inner canthus.
Other eye lid
cysts
Comedones are plugs
keratin sebum of
and within that
dilated orifice of hair follicles the
is usually caused by
implantation of epidermis
into the dermis following
trauma or surgery. It is a
slow-growing, round, firm,
superficial or
subcutaneous
containing keratin. lesion
Epidermal inclusion
cyst
Epidermoid cysts are lined with stratified
squamous keratinizing epithelium and contain
keratin
Other eye lid
cysts
Dermoid cyst is usually subcutaneous or deeper and is