ChalaziaChronic lipogranulomatousinflammation of the eyelidCaused by plugging ofmeibomianglands internal chalaziaZeisglands external chalaziasebaceous glands of eyelashesTreatmentEyelid hygieneTopi ID: 954295
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PediatricEyelid DisordersPeter MacIntosh, MDOphthalmic Plastic & Reconstructive SurgeryFebruary 8, 2018 ChalaziaChronic lipogranulomatousinflammati
on of the eyelidCaused by plugging ofmeibomianglands (internal chalaziaZeisglands (external chalaziasebaceous glands of eyelashes)TreatmentEyelid h
ygieneTopical steroid ointmentIntralesionalsteroid injectionsIncision and drainage www.drduerksen.com www.surgicalpathologyatlas.com HordeolaAcute
infectious abscess of eyelidUsually staphylococcalCan affectGland of zeis(external)Meibomiangland (internal)Hordeolaoften evolve into chalaziaTreat
mentEyelid hygieneTopical steroid/antibiotic ointmentSystemic Abxfor cellulitisIncision and drainage en.wikipedia.org/wiki/Stye MiliaMultiple tiny,
white lesionsCommon in infancyPrimaryon facial skin with hair folliclesSecondaryPilosebaceousunit traumaPathologyEpidermoidcyst filled with kerati
nTreatmentObserveIncision with a sharp needle and expression of contents MolluscumContangiosumPearly round papuleCentral umbilicatedFollicular conj
unctivitisPathologyPox viral infectionEpidermal hyperplasiaHendersonPatterson bodiesEosinophilic inclusions containing virusTreatmentObservationExc
isionCryotherapyCurettageAssociationsIn adults, consider AIDS Cryptophthalmos”Hidden Eye”SporadicSyndromicFraser syndrome (AR)Mutations i
n FRAS1 and FREM2SyndactylyGU malformationsOrofacial cleftingMusculoskeletal anomaliesManagementFull eyelid reconstruction Flap/graft Forehead skin
extends over globe and onto cheekwithout forming eyelids Coloboma0.7 / 10,000 live birthsIsolatedUnilateralUsually upper eyelidcorneal palpebral a
dhesionsMechanical forces e.g. amniotic membrane bandEmbryological error in ectodermal or mesodermal migration ColobomaSyndromicFraser syndromeGold
enharsyndromeTreacherCollins syndromeCHARGE www.nature.com Reviewofophthalmology.com ColobomaManagementEarly lubrication50% eyelid, close primarily
&#x-200;50% need lid sharing techniqueCaution for amblyopia Ankyloblepharon Web of skinPartial or complete eyelid fusionManagementClamp then cut wi
th scissors BCSC Epiblepharon Epiblepharon Lower eyelid pretarsalmuscle and skin override lid marginManagementObservation if no K issuesOften resol
ves with facial maturitySmall skin/muscle excisionAnterior lamellar everting suturesBCSC Epiblepharon Epicanthus Medial canthalfoldImmature midfaci
alPseudoesotropiaTarsalisUpper eyelidInversusLower eyelidPalpebralisEqual upper and lower eyelidBCSC Epicanthus ManagementObservationOften resolves
with facial maturityplastyplasty”Jumping man” plasty Mustardé, 1963 Euryblepharon Horizontal widening of the palpebral fissureInferior
displacement of lateral canthaltendonAntimongoloid slantManagementLateral tarsal stripBCSC Congenital BlepharophimosisSyndrome BCSC Congenital Blep
harophimosisSyndrome Ptosis BCSC Congenital BlepharophimosisSyndrome tosisEpicanthus inversus BCSC Congenital BlepharophimosisSyndrome tosispicanth
us inversusTelecanthus BCSC Telecanthusversus HypertelorismTelecanthusWidened intercanthaldistanceHypertelOrismTelorbitismWidened interorbital dist
ance and increased interpupillarydistance BCSC Congenital BlepharophimosisSyndrome tosispicanthus inversuselecanthusAutodomalDominantBCSC Congenita
l BlepharophimosisSyndromePtosisFrontalis suspensionHypertelorismand epicanthus inversusMedial canthoplastywith Zor YplastiesTransnasalwiring Tarsa
l Kink SyndromePrimary congenital entropion is very rareUsually involves medial lower eyelidTarsal kink may result in upper eyelid entropionRelated
to90 degree angle in tarsus (kink)ManagementHorizontal incision though kinkEverting sutures Congenital PtosisTheories:Disorder of muscle developme
ntDisorder of muscle innervationPathologyFibrosisDecreased density of skeletal muscles fibers Congenital PtosisVisioncarecentre.blogspot.comCharact
eristic findings:Absent or poorly developed eyelid creaseDecreased levatorfunctionEyelid lag in down gaze Congenital PtosisCharacteristic findings:
Absent or poorly developed eyelid creaseDecreased levatorfunctionEyelid lag in down gaze Congenital PtosisCharacteristic findings:Absent or poorly
developed eyelid creaseDecreased levatorfunctionEyelid lag in down gaze Congenital PtosisManagementVision unaffected: observeHead posturing/cosmeti
cSurgery after 6 months if possible 30 31 Many patient will have poor LF and need frontalis suspension FrontalisSuspension Sling MaterialsSilicon
e 74.3% Autogenousfascia lata34.9% Cadaveric fascia lata25.1% Supramid13.3% AakaluVK, Setabutr P. CurrentPtosisManagement: A NationalSurveyof ASO
PRS MembersOphthalPlastReconstrSurg. 2011 Feb 22. OphthalPlastReconstrSurg. 2011 JulAug;27(4):270 FrontalisSuspension 34 Unilateral versus bilate
ral surgery for unilateral ptosisControversialDo unilateral frontalis surgery to avoid surgery on the normal eyeDo bilateral frontalis surgery with
out excision of levatormuscle on normal sideDo bilateral frontalis surgery with excision of levatormuscle on normal sideDifficult to convince famil
y to do surgery on normal sideMostly do unilateral frontalis suspension ��37 &#x/MCI; 13;&#x 000;&#x/MCI; 13;&#x 000;Conclusi
onMany pediatric eyelid lesions are benignManage corneal exposure in patients with colobomaIn congenital ptosis, remember to measure:Lid creaseLeva