Surgical conditions affecting the eyelids

SURGICAL CONDITIONS AFFECTING THE EYELIDS

  • Chalazion (Tarsal cyst)
    • This is a cyst caused by the distension of a tarsal gland with secretion when it is inflammed. The size of the cyst may be about the size of a pea or more.
      • Incise and remove the contents of the cyst using a Chalazion forceps.
  • Hordeolum or stye
    • It is a localized inflammation of the hair follicles of the eye lashes due to staphylococcal infection. 
      • One or two neighboring eyelashes are plucked with foreceps so as to open the abscess and drain the pus. After draining the pus topical ophthalmic antibiotic eye ointment / drops are  indicated.
  • Dacryo – adenitis
    • Inflammation of lacrimal gland.
      • Fomentations, antibiotics, etc. Do not open before it is mature. Spontaneous rupture and healing usually happens.
  • Blepharitis
    • Blepharitis or inflammation of eyelids, causes ulceration of the palpebral borders. The ulcers contain a yellowish or greyish sticky discharge. The eyelids may stick together.
      • Symptomatic
      • Antibiotics may be used to control infection
  • Entropion -Congenital/acquired (View image...)
    • Inward deviation of the palpebral border, trichiasis, Distichiasis, etc.
    • Surgical correction
    • Anesthesia and control
      • In small animals - General anesthesia
      • In large animals auriculo palpebral nerve block
      • Block supra – orbital nerve as it comes out of supra – orbital foramen (sensory to upper lid) or by field block. The animal is controlled in standing or recumbent state.
    • Technique
      • A fold of skin parallel to the affected palpebral border is held by a forceps, enough to cause the correction of the abnormality, and is severed and removed.
      • The wound is sutured by ordinary apposition sutures. 
  •  Ectropion
    • Outward deviation of the palpebral border resulting in an abnormal exposure of the conjunctiva.
    • surgical correction
    • Anesthesia
      • In small animals - General anesthesia
      • Local infiltration
    • Site
      • It is ½ to 1 cm away from the free border of the eyelid.
    • Technique
      • A    'V ' – shaped cutaneous incision is put with the base of the “V” close to the affected border of the lid.
      • The triangular flap of skin outlined is worked loose from its apex by undercutting to effect correction of palpebral border.
      • The gap thus caused at the apex is closed by suturing the sides of the “V” incision to form a “Y”.
  • Trichiasis and Distichiasis
  • In trichiasis the eyelashes are directed slightly inwards so that they irritate the cornea and conjunctiva. Distichiasis is a congenital condition in which two rows of eyelashes are noticed on each lid and the inner row causes irritation of the conjunctiva. Distichiasis supposed to be hereditary.
      •  Epilation or plucking of the eyelashes.
      •  Destroying the hair roots by eletrocautery. 
      •  Complete removal of the hair roots by snipping the inner border of the lid. 
      •  Operation for entropion may prevent the eyelashes irriating the cornea.
  • Ptosis (Blepharo ptosis)
    • Dropping of the upper eyelid may be congenital. It may be due to paralysis of the seventh cranial nerve.
      • The condition may be temporary and may become normal without treatment. Surgical correction when necessary can be done as for entropion.
  • Lagophthalmos
    • A condition in which the eye cannot be completely closed. (Lagos = hare).
    • Causes
      • Paralysis of the orbicularis oculi muscle resulting from injury to the seventh cranial nerve.
      •  Prolapse of harderian gland
      •  Inflammed lacrimal gland
      •  Growth on the cornea.
      •  Staphyloma.
      •  Granulations on the edges of the eyelids.
      • Lagophthalmos causes drying of the cornea and conjunctiva
      • Remove the cause. Ophthalmic lubricants in the form of gel may be instilled at frequent intervals to moisten the cornea and conjunctiva.
      • The lids may be kept closed by means of one or two skin sutures over the closed lids.
  • Blepharospasm
    • It is a state of partial or complete closure of eyelids. It may be due to foreign particles irritating the cornea, early keratitis and conjunctivitis, photophobia, etc.
      • Blepharospasm is only a symptom and treatment depends on the cause.
      • Parasites in the conjunctival cul – de – sac
      • Thelazia rhodesii in cattle.
      • Prolapse of harderian gland
      • Prolapse of the nictitans  gland is common in the dog due to inflammatory swelling or hypertrophy. The gland protrudes outwards.
      • Surgical removal. 1 in 50,000 adrenalin may be applied locally to control haemorrhage.
      • Removal of membrane nictitans (Third eyelid).
    • Indications
      • Hypertrophy.
      • Neoplasm. , Carcinoma.
    • Anesthesia
      • General anethesia
    • Technique
      • Haemostatic mattress sutures are put along the base of the third eyelid to control haemorrhage and afterwards it is cut distal to the sutures.
  • Tumors of the eye lid
Last modified: Tuesday, 5 June 2012, 7:19 AM