Eyelid disorders

An eyelid disorder is any abnormal condition that affects the eyelids. The eyelids, which consist of thin folds of skin, muscle, and connective tissue, protect the eyes and spread tears over the front of the eyes. Some common lid problems include: stye, blepharitis, chalazion, entropion, ectropion, eyelid edema, and eyelid tumors. A stye is an infection of eyelid glands near the lidmargins, at the base of the lashes. A chalazion is an enlargement of a meibomian gland, usually not infectious. Initially, a chalazion may resemble a stye, but it usually grows larger and may also be located in the middle of the lid and be internal. Blepharitis is the inflammation of the eyelid margins, often with scales and crust. It can lead to eyelash loss, chalazia, styes, ectropion, corneal damage, excessive tearing, and chronic conjunctivitis. Entropion is a condition where the eyelid margin is turned inward; the eyelashes touch the eye and irritate the cornea. Ectropion is a condition where one or both eyelid margins turn outward, exposing the conjunctiva that covers the eye and lines the eyelid. Eyelid edema is a condition where the eyelids contain excessive fluid. Eyelids are susceptible to the same skin tumors as the skin over the rest of the body, including noncancerous tumors and cancerous tumors.Eyelid muscles are susceptible to sarcoma.

Styes are usually caused by bacterial staphylococcal infections. The symptomsare pain and inflammation near the eyelid margin. A chalazion is caused by ablockage in the outflow duct of a meibomian gland. Symptoms are inflammationand painful swelling. Blepharitis can be caused by bacterial infection, headlice, an overproduction of oil by the meibomian glands, or an unknown cause.It can be a chronic lifelong condition. Symptoms include itching, burning, afeeling of something in the eye, inflammation, and scales or crusts surrounding the eyelashes. Entropion usually results from aging, but is sometimes dueto a congenital defect, a spastic eyelid muscle, or a scar inside the lid. Symptoms are excessive tearing, redness, and discomfort. The usual cause of ectropion is aging, but it can also be caused by a spastic eyelid muscle, a scar, or allergies. Symptoms are excessive tearing and hardening of the eyelid conjunctiva. Eyelid edema is usually caused by allergic reactions, for example, to eye makeup, eyedrops or other drugs, or plants. Trichinosis, a disease caused by eating undercooked meat, also causes eyelid edema. Swelling can alsobe due to infection and lead to orbital cellulitis which can threaten vision. Symptoms include swelling, itching, redness, or pain. Eyelid tumors are caused by AIDS (Kaposi's sarcoma) or increased exposure to ultraviolet (UV) rays. They are usually painless and may or may not be pigmented.

To diagnose eyelid disorders, the doctor uses a slit lamp is used to magnifythe eyes. He/she may press on the lid margin to express oil from the meibomian glands or invert the lid to see inside it. Biopsy is used to diagnose cancerous tumors. Styes are treated with warm-hot compresses and sometimestopical antibiotics. About 25% of chalazia disappears on its own, but hot compresses may speed the process. Medication may need to be injected or the chalazion may need to be cut out. If a chalazion recurs on the same site, the possibility of sebaceous gland carcinoma should be investigated. Blepharitis istreated with hot compresses and antibiotic ointment, and by cleaning the eyelids. If the blepharitis doesn't clear up with treatment or is a chronic problem, the patient may have acne rosacea and need to see a dermatologist. Entropion and ectropion can be surgically corrected and treated with lubricating drops to keep the cornea moist. Patients with swollen eyelids should contact their eye doctor. A severely swollen lid can press on the eye and increase theintraocular pressure. An infection needs to be ruled out. The best treatmentfor allergic eyelid edema is to find and remove the substance causing the allergy. When that isn't possible, cold compresses and immunosuppresesive drugssuch as corticosteroid creams are helpful. For edema caused by trichinosis, the trichinosis must be treated. Cancerous tumors should be removed upon discovery, and noncancerous tumors before they grow enough to interfere with vision or eyelid function. Eyelid reconstruction sometimes accompanies tumor excision.

The prognosis for styes and chalazia is good to excellent. With treatment, blepharitis, ectropion, and entropion usually have good outcomes. The prognosisfor nonmalignant tumors is good after proper removal. The survival rate formalignant melanoma depends upon how early it was discovered and if it was completely removed. Sebaceous carcinomas are difficult to detect, so poor outcomes are more frequent. All eyelid disorders, if not treated, can lead to vision problems. Eyelid washing with baby shampoo and not rubbing the eyes and eyelids helps prevent styes, chalazia, blepharitis, and eyelid edema. Blepharitis is associated with dandruff, which can be controlled by washing the hair, scalp, and eyebrows with shampoo containing selenium sulfide. Avoiding allergens helps prevent allergic eyelid edema. Staying inside when pollen counts arehigh, and eliminating or removing eye makeup, or using hypo-allergenic makeup, helps in some cases. Sunscreen, UV-blocking sunglasses, and wide brimmed hats helps prevent eyelid tumors. Entropian and ectropian are unpreventable.

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