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DISORDERS OF LASHES - PowerPoint PPT Presentation


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DISORDERS OF LASHES. 1. Trichiasis. 2. Metaplastic lashes. 3. Distichiasis. 4. Phthiriasis palpebrarum . 5. Madarosis. 6. Poliosis. Trichiasis. Signs. Complications. Inferior punctate epitheliopathy. Posterior misdirection of normal lashes Most frequently affects lower lid.

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Presentation Transcript
slide1

DISORDERS OF LASHES

1. Trichiasis

2. Metaplastic lashes

3. Distichiasis

4. Phthiriasis palpebrarum

5. Madarosis

6. Poliosis

slide2

Trichiasis

Signs

Complications

  • Inferior punctate epitheliopathy
  • Posterior misdirection of normal lashes
  • Most frequently affects lower lid
  • Corneal ulceration and pannus
slide3

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

slide4

Metaplastic lashes

Signs

Causes

Aberrant lashes arising from meibomian

gland orifices

Cicatrizing conjunctivitis (ocular pemphigoid,

Stevens-Johnson, chemical burns)

slide5

Distichiasis

Signs

Treatment

  • Division into anterior and posterior
  • lamellae
  • Second row of lashes arising
  • from meibomian gland orifices
  • Cryotherapy to posterior lamella
  • Congenital
  • Reapposition of lamellae
  • Occasionally dominantly inherited
slide6

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

slide7

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

slide8

Poliosis

Premature localized whitening of hair

Ocular associations

  • Chronic anterior blepharitis
  • Sympathetic ophthalmitis

Systemic associations

  • Vogt-Koyanagi-Harada
  • syndrome
  • Waardenburg syndrome