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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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