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Oculoplastics and Lacrimal Disorders

Oculoplastics and Lacrimal Disorders. Epiphora Blepharitis Nasolacrimal duct occlusion Eyelid malposition Ectropion Entropion Eyelid tumours Basal cell carcinoma  Squamous cell carcinoma. Epiphora: Anatomy and Physiology. Blepharitis.

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Oculoplastics and Lacrimal Disorders

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  1. Oculoplastics and Lacrimal Disorders

  2. Epiphora Blepharitis Nasolacrimal duct occlusion Eyelid malposition Ectropion Entropion Eyelid tumours Basal cell carcinoma  Squamous cell carcinoma

  3. Epiphora: Anatomy and Physiology

  4. Blepharitis • Blepharitis involving predominantly the skin and lashes tends to be staphylococcal and (or) seborrheic in nature, whereas involvement of the meibomian glands may be either seborrheic, obstructive, or a combination (mixed). • The pathophysiology of blepharitis is a complex interaction of various factors, including abnormal lid-margin secretions, microbial organisms, and abnormalities of the tear film.

  5. OMG- I’ve been diagnosed with blepharitis Management • The mainstay of treatment is an eyelid hygiene regimen, which needs to be continued long term • Warmth • Massage • Cleansing • Topical antibiotics are used to reduce the bacterial load. • Topical corticosteroids and oral antibiotic preparations may be helpful in patients with marked inflammation with specialist monitoring

  6. Nasolacrimal duct obstruction • Occurs in approximately 5-6% of infants. • A sticky, watery eye with positive regurgitation on pressure over the lacrimal sac confirms the diagnosis. • As there is a high spontaneous rate of remission (60-90%) in the first year of life, probing should be delayed until 10-12 months of age. • Parents can be instructed to undertake lacrimal sac massage during the intervening period. Earlier probing is only justified if their is severe recurrent infection.

  7. Recanalisation: Probing to DCR • Probing of the naso-lacrimal duct is the first line of treatments • With persistent epiphora and recurrent infection, it may be necessary to perform a dacryocystorhinostomy (DCR). • Bicanalicular silicone incubation with Crawford, Juneman or Ritleng tubes can be carried out

  8. Eyelid malposition

  9. Tumours: Benign

  10. Steps to differentiating benign from malignant  Basal Cell Skin Cancer  • Small raised bump • Smooth, pearly appearance.  • Central necrotic area • Telangectasia • Sometimes like a scar that is flat and firm to the touch.

  11. Squamous Cell Carcinoma •  Sun exposed areas of skin such as the ears, lower lip, and the back of the hands • Skin that have been burned or exposed to chemicals or radiation • Often appears as a firm red bump, may feel scaly or bleed or develop a crust

  12. Sebaceous carcinoma Chronic blepharitis Recurrent chalazion Melanoma Change • Contour • Colour • Size

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