dr.

Sahilah Ermawati, SpM

1. Facial and Eyelid Anatomy
2. Classification and Management of Eyelid
Disorders
3. Periocular Malpositions and Involutional
Changes
Eyelids
 Skin and Subcutaneous Tissue

 Protractors.

 Orbital Septum .

 Orbital Fat.

 Retractors

 Tarsus.

 Conjunctiva
1. Congenital Anomalies
 Blepharophimosis Syndrome
 Congenital Ptosis of the Upper Eyelid
 Congeni tal Ect ropion
 Euryblepha ron
 Ankylobleph aron
 Epicanthus.
 Epiblepharon. .
 Congenital Entropion
 Congeni tal Distichiasis.
 Congenital Coloboma.
 Congen ital Eyelid Lesions
2. Acquired Eyelid Disorders.
Chalazion
Hordeolum.
Eyelid Edema.
Floppy Eyelid Syndrome .
Trichotillomania .
3. Eyelid neoplasme
Benign Eyelid Lesions .
Benign Adnexal Lesions
Benign Melanocytic Lesions
Premalignant Epidermal Lesions
In Situ Epithelial Malignancies
Premal ignant Melanocytic Lesions.
Malignant Eyelid Tumors.
4. Eyelid Trauma
 Blunt Trauma.

 Penetrating Trauma.

 Secondary Repair. .

 Dog and Human Bite

 Burns
- Ectropion - Involutional
- Entropion Periorbital Changes
- Symblepharon - Brow Ptosis
- Trichiasis
- Blepharoptosis
- Eyelid Retraction
- Facial Paralysis
- Facial Dystonia
 BLEPHAROPHYMOS
IS
1. Chalazion
 Chalazion is a focal inflammation of the
eyelids that results from an obstruction of
the meibomian glands (an internal posterior
hordeolum). This disorder is often associated
with rosacea and chronic blepharitis.
Treatment
- acute inflammatory phase, treatment consists
of warm compresses and appropriate eyelid
hygiene
- topical antibiotic or anti-infl ammatory ocular
medications can be used, they may have
minimal effect in resolving a chalazion.
- Acute secondary infection may be treated with
an antibiotic directed at skin flora.
Doxycycline or tetracycline given for systemic
 Chronic
 requiring surgical
management to facilitate
clearing of the inflammatory
mass. In most cases, the
greatest inflammatory
response is on the posterior
eyelid margin, and an
incision through tarsus and
conjunctiva is appropriate
for drainage.
 Sharp dissection and
excision of all necrot ic mater
ial, including the posterior
wall, are indicated.
-An acute infection (usua lly staphylococcal) can involve
the sebaceolls secretions in the glands of Zeis (external
hordeolum, or stye) or the meibomian glands (internal
hordeohan).
-In the case of external hordeola, the infection often
appears to center around an eyelash follicle, and the
eyelash can be plucked to promote drainage.
- Spontaneous resolution often occurs.
- application of hot compresses
- atopical antibiotic ointrnent is usually curative.
- Rarely, hordeola may progress to true superficial
cellulitis, or
even abscesses, of the eyelid.
- systemic antibiotic therapy and possible surgical incision
and drainage may be required.
 ocular irritation and
mild mucus discharge
 frequently worse on
awakening.
 chronic papillary
conjunc tivitis.
 i soft, rubbery, flaccid,
and easily everted
 Associations have
been reported with
obesity, keratoconus,
eyelid rubbing,
mechan ical pressure,
hypergly-cemia, and
sleep apnea.
 a history of prior skin cancer
 excess ive sun exposure, especially bl istering
sunburn during adolescence
 previous radiation therapy
 history of smoking
 Celtic or Scandinavian ancestry. with fair skin,
red hah. blue eyes
 immunosuppress ion
 slow, painless growth of a lesion
 ulceration, wi th intermittent drainage. bleeding,
and crusting
 irregular pigmentary changes
 destruction of no rmal eyelid margin architecture
(especially meihomian o rifices)
 and loss of cilia
 heaped-up, pearly, translucent margins with cen
tral ulceration
 fine telangiectasias
 loss of fine cutaneous wrin kles
 Cardinal rules in the management of eyelid
trauma include the following:
 Take a careful history.
 Record the best acuity for each eye .
 Thoroughly evaluate the globe and orbit.
 Obtain appropriate radiologic studies.
 Have a detail ed knowledge of eyelid and
orbital anatomy.
 Ensure the best possible primary repair.
 A basic eye examination should be performed,
- visual acuity,
- ocular motility.
- corneal assessment (slit-lamp examination).
- tests of tearing and protective mechanisms.
Ectropion :
 congenital

 involutional

 paralytic

 cicatricial

 mechanical
 A. Involutional.  C. Paralytic.
 B. Cicatricial.  D. Mechanical.
 congenital
 acute spastic
 involutional
 cicatricial
 Trichias is is an acquired misd irection of the
eyelashes.
 Management :
- mechanical epilation
- electrolysis
- radiofrequency
- Cryotherapy
- Argon laser
Terimakasih…
Wassalamu’alaikum wr wb
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