Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001
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DISORDERS OF LASHES
1. Trichiasis
2.Metaplastic lashes
3.Distichiasis
4.Phthiriasis palpebrarum
5.Madarosis
6.Poliosis
Trichiasis
Signs |
Complications |
• Posterior misdirection of normal lashes |
• |
Inferior punctate epitheliopathy |
• Most frequently affects lower lid |
• |
Corneal ulceration and pannus |
Treatment Options for Trichiasis
1.Epilation - but recurrences within few weeks
2.Electrolysis - but frequently repeated treatments required
3.Cryotherapy - for many lashes
4.Laser ablation - for few scattered lashes
5.Surgery - for localized crop resistant to other methods
Metaplastic lashes
Signs |
Causes |
Aberrant lashes arising from meibomian |
Cicatrizing conjunctivitis (ocular pemphigoid, |
gland orifices |
Stevens-Johnson, chemical burns) |
Distichiasis
Signs |
Treatment |
• |
Second row of lashes arising |
• |
Division into anterior and posterior |
|
from meibomian gland orifices |
|
lamellae |
• |
Congenital |
• |
Cryotherapy to posterior lamella |
• |
Occasionally dominantly inherited |
• |
Reapposition of lamellae |
Phthiriasis palpebrarum
•Infestation of lashes by pubic crab louse and its ova (nits)
•Typically affects children in poor hygenic conditions
|
|
Lice gripping base of lashes |
Nits and empty shells adhere to base of lashes |
|
|
Treatment - removal, destruction and delousing
Madarosis
Decrease in number or complete loss of lashes
Local causes
• Chronic anterior lid margin disease
• Infiltrating tumours
• Burns, radiotherapy or cryotherapy
Systemic causes
• Generalized alopecia
• Myxoedema
• SLE
• Syphilis
• Leprosy
Following removal
Poliosis
Premature localized whitening of hair
Ocular associations
• Chronic anterior blepharitis
• Sympathetic ophthalmitis
Systemic associations
• Vogt-Koyanagi-Harada
syndrome
• Waardenburg syndrome
CHRONIC MARGINAL BLEPHARITIS
1.Anterior
•Staphylococcal
•Seborrhoeic
2.Posterior
•Meibomianitis
•Meibomian seborrhoea
3. Treatment
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