Epiblepharon & Euryblepharon

Epiblepharon

 Extra fold of skin in the lower lid with inturning of eyelashes

 Nasal 1/3rd is most commonly affected

 Treatment: Plastic repair if necessary to prevent recurrent infection.

Euryblepharon

Rare, congenital, bilateral, not so serious condition

•  Palpebral apertures are larger than normal 

              and may be with epicanthus

• Excessive watering may be a problem due to more exposure

 Treatment:

 No treatment for most of the cases; lateral tarsorrhaphy for symptomatic cases.

Bilateral eyelids drooping Disease

Blepharophimosis Syndrome (Bilateral eyelid drooping disease)

 Autosomal dominant Condition
(Can be transmitted from both mother or father, usually express in every generation)

Features:

Syndrome consists of bilateral:

– Narrowing of vertical and horizontal palperbral apertures

– Telecanthus

– Inverse epicanthus folds

– Lateral ectropion and moderate to severe ptosis

 May be asymmetrical and without epicanthic folds

 Treatment: 

Plastic reconstruction of lids, along with bilateral brow suspension for ptosis.

Distichiasis

Distichiasis

 Hereditary and congenital condition

 Extra posterior row of cilia, occasionally present in all four lids

 Partial

Complete 

 They occupy the position of meibomian gland orifices

 Eyelashes may irritate cause to corneal epithelial defects

 May be also seen in Stevens Johnson’s syndrome—acquired distichiasis

 Treatment:

By cryotherapy or excision with grafting.

Congenital Lid Conditions: Ophthalmology Spot Diagnosis Series

Coloboma of the Eyelid

 A notch or defect of the lid margin

 Unilateral 

 or bilateral ; upper or lower

 Upper lid coloboma: At the junction of middle and inner thirds

 May be associated with Goldenhar syndrome

 Lower lid coloboma: At middle and outer thirds junction

 Associated with Treacher Collins syndrome

 May be acquired in traumatic cases

 Treatment: 

Urgent plastic repair at a very early age to prevent exposure keratitis and corneal ulcer.

Vertigo: what are the causes!

Vertigo

Most important causes of vertigo

Disorder	Notes
Viral labyrinthitis	Recent viral infection Sudden onset Nausea and vomiting Hearing may be affected
Vestibular neuritis	Recent viral infection Recurrent vertigo attacks lasting hours or days No hearing loss
Benign paroxysmal positional vertigo	Gradual onset Triggered by change in head position Each episode lasts 10-20 seconds
Meniere's disease	Associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears
Vertebrobasilar ischaemia	Elderly patient Dizziness on extension of neck
Acoustic neuroma	Hearing loss, vertigo, tinnitus Absent corneal reflex is important sign Associated with neurofibromatosis type 2