home Audience 5 Causes of deformation of eyelids. Diseases of the eyelids. Surgical correction of lower eyelid inversion

Causes of deformation of eyelids. Diseases of the eyelids. Surgical correction of lower eyelid inversion

Upper eyelid ptosis(syn. blepharoptosis) - abnormally low position of the eyelid in relation to the eyeball. This pathology can be congenital or acquired.

Congenital ptosis- a disease with an autosomal dominant type of inheritance, in which isolated dystrophy of the muscle that lifts the upper eyelid develops (myogenic), or there is aplasia of the oculomotor nerve nucleus (neurogenic). There are congenital ptosis with normal function of the superior rectus muscle (the most common type of congenital ptosis) and ptosis with weakness of this muscle. Ptosis is often unilateral, but can occur in both eyes. With partial ptosis, the child raises the eyelids using the frontal muscles and throws back the head (stargazer position). The superior palpebral groove is usually weak or absent. When looking straight, the upper eyelid is lowered, and when looking down, it is located above the opposite one.

Palpebromandibular syndrome(Hun syndrome) is a rarely observed congenital, usually unilateral, ptosis associated with synkinetic retraction of the drooping upper eyelid upon stimulation of the pterygoid muscle on the side of the ptosis (Fig. 7.3, a). Involuntary lifting of the drooping upper eyelid occurs when chewing, opening the mouth or yawning (Fig. 7.3, b), and abduction of the lower jaw in the direction opposite to ptosis can also be accompanied by retraction of the upper eyelid (Fig. 7.3, c). In this syndrome, the muscle that lifts the upper eyelid receives innervation from the motor branches of the trigeminal nerve. Pathological synkinesis of this type is caused by lesions of the brain stem, often complicated by amblyopia or strabismus.

Blepharophimosis- a rare developmental anomaly caused by shortening and narrowing of the palpebral fissure, bilateral ptosis, with an autosomal dominant type of inheritance. It is characterized by poor function of the levator palpebrae superioris, epicanthus, and inversion of the lower eyelid.

Acquired ptosis is observed much more often than congenital ptosis. Depending on the origin, neurogenic, myogenic, aponeurotic and mechanical acquired ptosis are distinguished.

Neurogenic ptosis in oculomotor nerve palsy is usually unilateral and complete, most often caused by diabetic neuropathy and intracranial aneurysms, tumors, trauma and inflammation. With complete paralysis of the oculomotor nerve, the pathology of the extraocular muscles and clinical manifestations of internal ophthalmoplegia are determined: loss of accommodation and pupillary reflexes, mydriasis. Thus, an aneurysm of the internal carotid artery inside the cavernous sinus can lead to complete external ophthalmoplegia with anesthesia of the area of innervation of the eye and the infraorbital branch of the trigeminal nerve.

Ptosis can be induced protectively in the treatment of corneal ulcers that do not heal due to non-closing palpebral fissure in lagophthalmos. The effect of chemical denervation of the muscle that lifts the upper eyelid with botulinum toxin is temporary (about 3 months), and is usually sufficient to stop the corneal process. This treatment method is an alternative to blepharorrhaphy (suturing the eyelids).

Ptosis in Horner's syndrome (usually acquired, but can also be congenital) is caused by a violation of the sympathetic innervation of Müllerian smooth muscle. This syndrome is characterized by some narrowing of the palpebral fissure due to drooping of the upper eyelid by 1-2 mm and a slight elevation of the lower eyelid, miosis, and impaired sweating on the corresponding half of the face or eyelids.

Myogenic ptosis occurs with myasthenia gravis, often bilateral, and can be asymmetrical. The severity of ptosis varies from day to day, it is provoked by exercise and can be combined with double vision. The endorphin test temporarily eliminates muscle weakness, corrects ptosis, and confirms the diagnosis of myasthenia gravis.

Aponeurotic ptosis- a very common type of age-related ptosis; characterized by the fact that the tendon of the muscle that lifts the upper eyelid is partially torn from the tarsal (cartilaginous) plate. Aponeurotic ptosis can be post-traumatic; It is believed that in a large number of cases postoperative ptosis has such a development mechanism.

Mechanical ptosis occurs when there is horizontal shortening of the eyelid of tumor or scar origin, as well as in the absence of the eyeball.

In preschool children, ptosis leads to persistent vision loss. Early surgical treatment of severe ptosis can prevent the development of amblyopia. If the mobility of the upper eyelid is poor (0-5 mm), it is advisable to suspend it from the frontalis muscle. In the presence of a moderately pronounced excursion of the eyelid (6-10 mm), ptosis is corrected by resection of the muscle that lifts the upper eyelid. When congenital ptosis is combined with dysfunction of the superior rectus muscle, resection of the levator tendon is performed to a greater extent. High eyelid excursion (more than 10 mm) allows resection (duplication) of the levator aponeurosis or Müller muscle.

Treatment of acquired pathology depends on the etiology and magnitude of ptosis, as well as on the mobility of the eyelid. A large number of techniques have been proposed, but the principles of treatment remain unchanged. Neurogenic ptosis in adults requires early conservative treatment. In all other cases, surgical treatment is advisable.

When the eyelid droops by 1-3 mm and has good trans-conjunctival mobility, resection of the Müller muscle is performed.

In the case of moderately severe ptosis (3-4 mm) and good or satisfactory eyelid mobility, surgery on the muscle that lifts the upper eyelid (tendon plasty, refixation, resection or duplication) is indicated.

With minimal eyelid mobility, it is suspended from the frontalis muscle, which provides mechanical lifting of the eyelid when raising the eyebrow. The cosmetic and functional results of this operation are worse than the effect of interventions on the levator muscles of the upper eyelid, but in this category of patients there is no alternative to suspension.

To mechanically lift the eyelid, it is possible to use special arms that are fixed to the frames of glasses, or use special contact lenses. These devices are generally poorly tolerated and are therefore rarely used.

>With good eyelid mobility, the effect of surgical treatment is high and stable.

Turn of the century(syn. entropien) - a disease in which the edge of the eyelid and eyelashes are turned towards the eyeball. This leads to constant irritation of the eye, the formation of erosion and ulcers of the cornea, injection of conjunctival vessels, and lacrimation. The following forms of entropion of the eyelids are distinguished: congenital, age-related, spastic, cicatricial. Congenital entropion of the eyelid is more often observed in representatives of the Mongoloid race and is a consequence of thickening of the skin and hypertrophy of the fibers of the orbicularis oculi muscle at the ciliary edge. Treatment of congenital volvulus consists of dosed semilunar resection of the skin and orbicularis oculi muscle, and if necessary, resection can be supplemented by the application of everting sutures. Congenital volvulus often disappears during the first months of a child's life.

Age-related entropion occurs due to sprain of the eyelid ligaments, atony of the lower eyelid retractor, and instability of the tarsal plate. Age-related entropion is corrected by horizontal shortening of the external eyelid ligament, retractor plasty, resection of a musculocutaneous flap, as well as a combination of these techniques. The prognosis is good.

Spastic volvulus is characterized by age-related stretching of the structures of the lower eyelid, which, with age-related enophthalmos, leads to instability of the lower eyelid. The fibers of the orbicularis oculi muscle gradually shift towards the edge of the eyelid, and their hypertrophy occurs. The occurrence of such an inversion of the eyelid is provoked by blepharospasm. In case of spastic entropion of the eyelid, a combination of horizontal shortening of its external ligament is justified, and if necessary, the operation is supplemented with plastic surgery of the lower eyelid retractor and removal of a skin flap of the lower eyelid. Unlike age-related bloat, spastic bloat recurs more often.

Eversion of the edge of the eyelid(syn. ectropion) is a disease in which the eyelid moves away from the eye, resulting in exposure of the palpebral and bulbar conjunctiva. Inversion of the lower eyelid almost always occurs. Even with a slight degree of inversion of the lower eyelid, the lower lacrimal opening is displaced, which leads to lacrimation. The epithelium of the palpebral part of the conjunctiva of the lower eyelid begins to keratinize. The eyelid sags, inversion of the lower lacrimal punctum leads to lacrimation and constant lacrimation, which is painful for patients, and the development of chronic blepharitis and conjunctivitis. Severe lagophthalmos can contribute to the formation of corneal ulcers.

There are the following forms of eversion of the eyelid margin: congenital, carpal paralytic, cicatricial.

Congenital inversion, especially isolated, is the most rarely observed form; caused by shortening of the outer - musculocutaneous - plate of the eyelid. With a low degree of eyelid maladaptation, as a rule, there is no need for surgical correction.

Age inversion- the most common form; Caused by excessive stretching of the eyelid ligaments, which causes the eyelid to sag. Surgical treatment is horizontal shortening of the lower eyelid (Fig. 7.4). In case of isolated eversion of the inferior lacrimal punctum, vertical shortening of the conjunctiva and sutures are applied on an outpatient basis to reduce the inferior lacrimal punctum.

Paralytic ectropion is observed with facial nerve paralysis and can occur after denervation of the fibers of the orbicularis oculi muscle (botulinum toxin). Treatment consists of keeping the eye constantly moist; During the treatment period, the eyelids are sealed. If the pathology persists for a long time (more than 6 months), horizontal shortening of the external ligament of the eyelid is performed, and if necessary, blepharorrhaphy is performed.

Cicatricial eversion develops as a result of burns, after injuries and operations, and during skin infections. At the time of a thermal burn, closing your eyes tightly can prevent damage to the edges of the eyelids. Treatment of cicatricial ectropion is complex and usually long-term. In the earliest stages after the onset of inversion, it is advisable to perform blepharorrhaphy, and in the delayed period, free skin grafting may be required. There is often a need for local application of proteolytic enzymes and physical therapy. The prognosis for appropriate intervention is good, the effect is usually stable, but in severe cases relapses are possible.

Blepharochalasis- a rare disease caused by repeated swelling of the eyelids, leading to overhanging atrophic skin folds. The disease begins during puberty with the onset of edema, the severity of which decreases over the years. Edema leads to thinning of the skin like tissue paper. A skin fold forms on the upper eyelid, which hangs over the palpebral fissure, causing a cosmetic defect and limiting the field of vision from above. Treatment consists of removing excess skin and, if necessary, performing repair of the tendon of the levator palpebrae superioris muscle.

Inflammation of the eyelids is a whole group of different diseases, having a diverse etiology, with the development of inflammatory processes of the edges of the lower or upper eyelids.

This group is one of the most common problems of the human visual system. It significantly affects the patient’s condition, reducing his performance.

Symptoms of inflammation of the lower or upper eyelid

It is important to understand that the inflammatory process of the eyes is complex of various diseases with a wide variety of causes. This is why this problem has a lot of symptoms, the main ones being the following:

swelling on the eyelid;
redness eyes;
swelling;
soreness when performing palpation;
purulent discharge from the area of swelling;
acquisition yellow conjunctiva;
strong headache etc.

Concerning most typical symptoms of inflammation upper century, then these include swelling and redness. Against this background, swelling often appears during the development of the disease. The ciliary roots may become covered with small scales, having a gray-yellow tint.

With the same problems lower eyelid swelling and redness reach right up to the inner edge of the eye, and he begins react painfully to the wind and water. If treatment is not timely, there is a risk that the disease will progress to purulent accumulation.

Reference. Thus, the symptoms of the disease directly depend on etiology, place localization of the disease, immunity person, as well as timeliness of treatment.

Diagnostics

Before treating inflammation of the eyelids, it is imperative to contact a medical facility to diagnose the disease. The doctor can indicate the cause of the development of the disease, after which he selects rational type of therapy.

Diagnostics consists of the following points:

inspection patient;
collection of relevant medical history;
definition visual acuity;
biomicroscopy eyes;
state determination refraction and accommodation etc.

Most often, after examination, an ophthalmologist can immediately determine the cause of the disease. Other times he takes smear for analysis to identify which microorganism influenced the development of the disease.

Causes of eye disease

In most cases, eye inflammation is caused by infection. But at the same time, ophthalmologists note that a problem may also arise due to strong external influence or psychosomatic impact.

TO most common reasons that cause inflammation on the eyelids include:

failure to comply sanitary and hygienic rules;
long-lasting and very intense influence ultraviolet;
decrease in level immune system person;
any damage mechanical or chemical nature;
usage low-quality cosmetics;

difficulties with metabolic processes and digestion;
farsightedness;
sinusitis;
diseases that are localized in the oral cavity;
level problems hormones;
stressful situations;
allergic reactions;
the impact of certain microorganisms: viruses, bacteria and fungi.

Most of the above reasons create conditions under which opportunistic pathogenic microorganisms multiply on the eyelid. Among them it is worth highlighting staphylococci, streptococci, Pseudomonas aeruginosa etc.

How does the disease progress?

The course of the disease can be completely different depending on its type. There are such possible development options Problems:

Barley. The cause is infection staphylococcus, which is localized in the sebaceous gland. Initially occurs swelling extreme part of the lower or upper eyelid. The skin gradually becomes red tint. The same applies to the conjunctiva directly next to the area of the inflammatory process. The abscess can take several days to mature and is accompanied by minor pain. After this happens breakthrough of purulent masses out.

Photo 1. Ripe stye on the upper eyelid of the right eye; it is not long until the abscess breaks through.

Meibomite. This disease can be caused by any coccal microorganisms. The lesion concerns the meibomian gland. The disease often progresses from acute to chronic form. This leads to the patient periodically experiencing barley on the inside century. Since pus is released directly into the eye after a breakthrough, doctors recommend removing the pathology by surgical stripping.
Furuncle. Its occurrence is influenced by non-compliance with hygiene rules, demodex infection, etc. Against the background of damage or diabetes, this disease also appears. In the age of man there arises dense area with the presence in it purulent contents. As a result, swelling appears. As a treatment, doctors recommend surgical removal, which often leaves small scar.
Blepharitis. The cause of this disease is bacterial infection. The person initially feels heaviness in the eye, which becomes sensitive to light. The eyelids gradually become reddish tint And itchy. Against this background, the eyes quickly get tired, eyelashes may fall out.

Photo 2. An eye infected with blepharitis: the eyelids are red and flaky, with yellowish scales visible on them.

Impetigo. As a result of this disease, along the entire line of the eyelid appears mass of small pustules. They tend to gradually disappear even without appropriate therapy. The disease is transmitted by contact, so it is common in children with staph or streptococcal infections.
Abscess and phlegmon. This disease most often occurs as complication of other diseases. A purulent lesion on the eye appears quite suddenly. This ultimately causes severe pain. They disappear only after the pus comes out.
Molluscum contagiosum. The etiology lies in poxyvirus. Most often, this type of disease affects children or adults with problems with the immune system. Appear on the skin of the eyelids painless small blisters. If the condition is not treated, there is a risk of developing other eye problems.

Knowing how the disease progresses, we can assume what causes it. This significantly solves the problem determining the method of treatment.

Types of inflammation

In some cases, the inflammatory process has specific symptoms. This helps the doctor make a diagnosis.

There are such types and features eye inflammation:

Demodectic inflammation. This type of disease is characterized by what causes it Demodex. This mite lives in the eyelash bulbs of the eye. It can be acquired due to the patient's contact with birds. It is in their down and feathers that this pathogen is located.
Scaly inflammation. It is often associated with a disease such as seborrhea. Its main and characteristic signs include narrowing of the eye slit, the formation of scales of various shades (white, gray, yellow), severe itching, increased sensitivity to wind, dust and light.
Angular inflammation. The main feature of the disease is the localization of inflammation in the inner corner eyes. It is in it that the angular process occurs with the formation of a foamy secretion.
Meibomian inflammation. This type of disease is recognized as one of the the most difficult. This is due to the fact that not only the eye is involved in the inflammation process, but also meibomian sinuses. As a result, pus begins to accumulate in a person. In addition to the formation of crusts, foamy-purulent contents appear at the edges of the eyes. May be accompanied by conjunctivitis and redness.

Photo 3. Meibomitis that has developed on the upper eyelid: pus accumulates inside the meibomian sinus.

Ulcerative inflammation. This is also one of the most complex types of the disease. On the lash line a person develops small sores. As a result, the patient feels pain. Small amounts may be released from affected areas blood. As a result, the patient often eyelashes fall out.
Allergic inflammation. In this case, patients are concerned swelling eye and permanent itching. As a result, the level of lacrimation.

Important! The doctor must select treatment depending on the type of illness. So ignore going to a medical facility under no circumstances is it worth it.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Eye- one of the most complex organs of the human body in its structure. It includes a range of anatomical and physiological entities, each of which can be susceptible to many different diseases. Accordingly, in medical science it is customary to divide pathologies characteristic of our visual analyzer.

Characteristic symptoms

redness;
peeling;
rashes of an inflammatory or blistering nature;

Demodicosis is chronic, characterized by periodic exacerbations in the spring and autumn. Its therapy is quite long and effective only with strict adherence to all personal hygiene measures to prevent re-infection. Treatment is carried out by a dermatologist, usually on an outpatient basis. It includes the use of specific external agents in combination with the ingestion of quinoline drugs and antihistamines.

Coloboma

Coloboma of the eyelid is a segmental defect of the eyelid, involving all its layers. In most cases, it is a congenital disorder, but can also develop as a result of injury or complications. It occurs more often on the upper eyelids, although sometimes it affects the lower ones. Usually the defect has the shape of a triangle, the base of which is located at the ciliary edge of the eyelid. Since the defect covers all layers of the eyelid, there are no glands and eyelashes in the area of the coloboma.
This disease poses a very serious danger to the eye, as it often leads to secondary diseases of the organs of vision, such as keratitis or corneal dystrophy.

The most effective method of treatment is surgery, which consists of excision of the coloboma and moving a musculocutaneous flap to the site of the defect. With the help of such plastic surgery, a physiological edge of the eyelid is formed, which prevents the development of complications, as well as ptosis or entropion.

Ankyloblepharon

This pathology is characterized by partial or complete fusion of the edges of the eyelids. This disease can be either congenital or acquired, resulting from scar changes on the edges of the eyelids due to injuries or burns. Treatment of the pathology is surgical.

Ptosis

Ptosis is an abnormally low position of the upper eyelids in relation to the eyeballs. This pathology can be congenital or acquired.

Causes of ptosis

damage to the oculomotor nerve ( in such cases, ptosis accompanies paralysis of the muscles of the eyeball, which is manifested by double vision in the eyes and dilation of the pupil);
Horner's syndrome, which is accompanied by a lack of sweating on the affected side and constriction of the pupil;
severe muscle pathologies, which manifest themselves as weakness and increased fatigue;
isolated lesion of the levator palpebrae superioris muscle;
many neurological diseases ( strokes, encephalitis, etc.).

Treatment of this disease is predominantly surgical with mandatory treatment of the underlying pathology.

Turn of the century

When the eyelid turns in, its free edge turns towards the eyeball. The cause of the development of pathology is spastic or convulsive contractions of any part of the orbicularis oculi muscle. In addition, this may be a consequence of scar tightening of the conjunctiva and cartilage of the eyelid, which occurs in some chronic eye diseases, for example, trachoma.

With entropion or entropion, the eyelashes rub against the surface of the conjunctiva and cornea, which quickly leads to irritation, redness of the eye and profuse lacrimation. The most effective method of treating entropion is surgery.

Eversion of the century

When the edge of the eyelid turns outward, it is called ectropion. It may be small ( the eyelid simply does not fit tightly to the eyeball or droops a little), and may have significant severity ( the conjunctiva turns out in some area or throughout the entire century, gradually dries and enlarges).
The lacrimal punctum also moves away from the eye along with the eyelid - this leads to damage to the skin around the eye and lacrimation. Failure to close the palpebral fissure can lead to the development of various infectious diseases and keratitis with clouding of the cornea.

Causes of ectropion

age-related changes in which the lower eyelid droops due to weakening of the eye muscles;
paralysis of the orbicularis oculi muscle ( paralytic and spastic ectropion);
tightening of the skin of the eyelids after burns, injuries, systemic lupus erythematosus, etc. ( cicatricial eversion).

For spastic inversion, therapy is used to treat its cause. For other types of ectropion, surgical intervention is indicated.

Blepharitis

Blepharitis is a marginal inflammation of the eyelids.

Causes of blepharitis

chronic allergic and infectious diseases;
viral infections;
lack of vitamins;
diseases of the digestive tract, teeth and nasopharynx;
untreated vision pathologies.

The main causative agent of the infectious nature of the disease is Staphylococcus aureus. Also, the development of blepharitis contributes to constant irritation of the eye by dust, smoke and wind. The pathological condition, as a rule, occurs with persistent decreases in immunity. In addition, allergic blepharitis may develop as a result of contact of cosmetics that irritate the skin on the eyelids or eyes, or as a result of taking certain medications.

Symptoms of blepharitis
In mild cases, the edges of the eyelids become red, slightly swollen and covered at the roots of the eyelashes with small gray-white scales that are easily separated. Patients complain of a feeling of heaviness in the eyelids, itching under the eyelashes and their loss. The eyes water, get tired very quickly, are sensitive to bright light, wind, dust, etc. In more severe cases, purulent crusts form along the edges of the eyelids, and when separated, small bleeding ulcers are exposed. Their scarring can lead to deformation of the eyelids and abnormal growth of eyelashes, which can even grow towards the eye. Eyelashes become thin, sparse, and fall out easily. Sometimes the disease may not cause the formation of ulcers and scales. In this case, the reddened edges of the eyelids will be thickened and moisturized, and when pressure is applied to the cartilage, an oily secretion will be released.

Treatment of blepharitis
With ulcerative blepharitis, it is necessary to carefully observe eyelid hygiene. Discharge and crusts are removed with a damp cotton swab. If the crusts are rough, they must first be softened with wet lotions or ointment containing corticosteroids and antibiotics.

With seborrheic blepharitis, it is also necessary to monitor eyelid hygiene. In addition, hydrocortisone ointment and eye drops are used ( ophtagel).

For demodectic blepharitis, the main goal of therapy is to reduce the level of mite damage. The eyelids should be wiped twice a day with a swab containing saline solution. The edges of the eyelids are lubricated with hydrocortisone and dexagentamicin ointment. It is important that the edges of the eyelids are covered with ointment before going to bed - this will disrupt the life cycle of the mites.

In the treatment of allergic blepharitis, the first place is elimination of the allergen. In addition, therapy includes long-term use of antiallergic eye drops and lubrication of the edges of the eyelids with corticosteroid ointment. For infectious-allergic blepharitis, use dexagentamicin ointment or maxitrol.

Abscess of the century

An eyelid abscess is a limited inflammation of the eyelid tissue with the formation of a cavity in it that is filled with pus.
Most often, an abscess develops as a consequence of an infected eyelid wound.
Causes of eyelid abscess

ulcerative blepharitis;
purulent processes in the orbit of the eye and paranasal sinuses.

With an abscess, the eyelid is swollen, painful, the skin is red, hot to the touch and tense. Gradually, the affected area begins to acquire a yellowish tint, and a softening area appears. The abscess can open spontaneously with the release of pus - in this case, the inflammatory phenomena subside, but often a fistula remains, which indicates that the source of inflammation has not yet been eliminated. For treatment, sulfonamides and antibiotics are prescribed, as well as sulfadimethoxine orally. In addition, when the abscess begins to soften, it is better to surgically open it under sterile conditions.

Trichiasis

Trichiasis is the name given to abnormal growth and placement of eyelashes, which occurs as a result of ulcerative blepharitis, trachoma and other pathologies. The eyelashes are directed towards the eye, irritating the cornea and conjunctiva, which causes inflammation. The main method of treatment is surgical.

Swelling of the eyelid

Swelling of the eyelid is caused by an abnormal increase in fluid content in its subcutaneous tissue.

Edema is caused by:

heart, kidney and thyroid diseases;
injuries;
lymphatic drainage disorders;
leaks of cranial fluid.

The development of eyelid edema is facilitated by the high extensibility of the skin in this area, the rich blood supply to the eyelids, the very loose structure of the subcutaneous tissue, as well as its ability to accumulate fluid.

Clinically, inflammatory edema is manifested by a local increase in temperature, pronounced redness of the skin and pain when palpated. Most often such swelling is one-sided. Pain and enlargement of the lymph nodes are sometimes noted. With non-inflammatory edema, the skin of the eyelids is “cold”, pale, and palpation of the eyelid is painless. In these cases, the swelling is usually bilateral, more pronounced in the morning and often combined with swelling of the legs or abdomen.

Allergic edema is usually significantly pronounced, develops suddenly, is not accompanied by pain and quickly disappears. Its occurrence is often preceded by a feeling of weakness, headache and increased fatigue. The reason for the development of such edema is an allergic reaction of the body to any irritants.

Barley

Barley is an acute purulent inflammation of the sebaceous gland located near the ciliary bulb or hair follicle of the eyelash. Internal barley is also distinguished, caused by inflammation of the meibomian gland lobule ( meibomite).

Most often, stye on the eye is caused by a bacterial infection ( in 90% of cases it is Staphylococcus aureus) with weakened immunity in patients with reduced resistance to various infections. Barley often occurs against the background of a cold, inflammation of the paranasal sinuses, tonsillitis, dental diseases, disorders in the gastrointestinal tract, helminthic infestations, furunculosis, diabetes mellitus.

Chalazion

A chalazion is a cyst of the sebaceous gland of the eyelid, resulting from a blockage of its duct caused by chronic inflammation of the surrounding tissues. In such cases, the contents of the gland turn into a jelly-like mass, and on the eyelid you can feel a dense formation the size of a small pea. The skin in this place is mobile and raised, and on the side of the conjunctiva there is an area of redness with a grayish zone in the very center.

Causes of chalazion

effects of barley;
decreased protective functions of the body;
colds;
hypothermia;
violations of personal hygiene rules;
long-term wearing of uncomfortable contact lenses;
very oily skin;
increased production of the sebaceous gland.

For treatment in the early stages, bactericidal drops and ointments with antibiotics are used. The radical method is the surgical method. On an outpatient basis, under local anesthesia, a special clamp is applied to the eyelid, and the contents of the chalazion are removed through an incision in the skin or conjunctiva along with the capsule. The entire operation takes only a few minutes.

Lagophthalmos

Lagophthalmos is a condition of incomplete closure of the palpebral fissure. It develops against the background of neuritis, after eyelid injuries, and can also be a consequence of congenital shortening of the eyelids. Due to excessive lighting, this pathology can lead to damage to the cornea.
In addition, lagophthalmos causes drying of the cornea and conjunctiva, which is complicated by erosion or keratitis. In addition to treating the underlying disease, disinfecting drops and “artificial tears” are instilled into the eye. To prevent drying out and to prevent infectious lesions, antibiotic ointment, sterile petroleum jelly or sea buckthorn oil are placed in the eye at night. In severe forms of lagophthalmos, surgical intervention with partial suturing of the palpebral fissure is possible.

Blepharospasm

Blepharospasm is an involuntary contraction of the muscles of the eyelid. Most often it is associated with other eye diseases.

There are 3 types of blepharospasm:
1. protective , which occurs when irritation and inflammation of the anterior part of the eye, mucous membrane or skin of the eyelids;
2. essential , which is of a neurotic obsessive nature ( teak), but can also have an organic basis, for example in tetany, chorea or epilepsy;
3. senile , occurring in older people as an isolated syndrome.
Treatment of this pathology is based on eliminating the underlying disease.

Blepharochalasis

Blepharochalasis is characterized by an increase in the amount of tissue in the upper eyelid. When it gathers into folds, it hangs over the eye and interferes with vision. More often the disease occurs in young girls. Its causes have not been fully established, but the influence of vascular, endocrine and neurotic disorders is assumed. Treatment of blepharochalasis is surgical - with excision of excess tissue and plastic surgery of the upper eyelid.

Diseases of the lacrimal organs

Dacryocystitis

Dacryocystitis is an inflammation of the lacrimal sac, which is often chronic. One of the most common eye diseases in children. The cause of dacryocystitis is narrowing or blockage of the nasolacrimal duct due to inflammation in the nasal cavity, in the paranasal sinuses or in the bones that surround the lacrimal sac. When a blockage occurs, the outflow of tear fluid is delayed, which leads to the proliferation of microorganisms that cause inflammation of the mucous membranes of the lacrimal sac.

Main symptoms of dacryocystitis

lacrimation;
swelling of the lacrimal sac;
purulent discharge from the affected eye.

Treatment of dacryocystitis consists of prescribing antibacterial therapy, washing the lacrimal ducts and pushing the lacrimal sac, which allows you to break through the obstruction in the nasolacrimal duct.

Tearing

Lacrimation or lacrimation is the excessive secretion of tear fluid. It may be associated with increased production of tear fluid or disturbances in its outflow ( see Dacryocystitis). Excess tear fluid is caused by chemical, mechanical or light irritants, as well as inflammation of the cornea or conjunctiva.
Lacrimation can also be of a reflex nature, appearing in the cold, when the mucous membranes of the nose are irritated, during strong emotional experiences, etc. In most cases, to stop lacrimation, it is enough to remove the irritating factor.

Diseases of the conjunctiva

Conjunctivitis

Conjunctivitis is an inflammatory eye disease that affects the mucous membrane and is caused in most cases by a viral or, less commonly, bacterial infection.
Acute conjunctivitis is characterized by:

pain in the eyes;
purulent or mucopurulent discharge;
swelling of the eyelids;
swelling and redness of the conjunctiva;

Chronic conjunctivitis manifests itself:

itching and burning in the eyes;
feeling of “sand behind the eyelids”;
lacrimation;
eye fatigue;
redness of the whites of the eyes.

Viral conjunctivitis often associated with herpes infection or adenoviral infection of the upper respiratory tract. It can occur with a common cold or sore throat. It manifests itself as lacrimation, intermittent itching, moderate blepharospasm, and scanty non-purulent discharge. In children, this disease may be accompanied by the appearance of films or follicles. Artificial tear drops and warm compresses are used to treat a viral eye disease. If the symptoms are severe, drops with corticosteroids are used. A specific antiviral drug for the treatment of viral conjunctivitis is eye drops containing interferon. If conjunctivitis is caused by a herpes virus, acyclovir and ophthalmoferon drops are prescribed.

Bacterial conjunctivitis caused by bacteria that produce pus. One of the first symptoms is an opaque, sticky, yellowish or gray discharge from the eye, which causes the eyelids to stick together, especially after a night's sleep. However, bacteria such as chlamydia may not cause discharge or significant redness of the conjunctiva. In some patients, bacterial conjunctivitis may only be manifested by the sensation of a foreign body in the eye. Bacterial conjunctivitis is also characterized by dryness of the infected eye and surrounding skin. Like viral conjunctivitis, bacterial conjunctivitis most often first affects only one eye, and then can easily spread to the second. Mild forms of bacterial conjunctivitis do not always require drug treatment and can go away on their own with strict hygiene. However, tetracycline eye ointment or antibiotic eye drops will greatly speed up the healing process.

Trachoma– a type of conjunctivitis caused by chlamydia.
Symptoms of trachoma: redness and thickening of the conjunctiva, the formation of grayish grains on it ( follicles), which consistently disintegrate and scar. In the absence of adequate treatment, this disease leads to purulent inflammation and ulceration of the cornea, entropion of the eyelids, the formation of cataracts and even blindness.
Trachoma can be transmitted through hands and objects ( scarves, towels, etc.), contaminated with secretions ( pus, mucus or tears). Usually both eyes are affected. Antibiotics and sulfonamides are used in the treatment of trachoma. With the development of trichiasis and some other complications, surgical methods are sometimes used.

Blennorea is an acute purulent conjunctivitis that is caused by gonococcus. One of the common eye diseases in newborns who become infected from a mother with gonorrhea during childbirth. Blenorrheal conjunctivitis is characterized by serous-bloody discharge, and after 3 - 4 days - profuse purulent discharge. If left untreated, corneal ulcers occur, which can result in blindness.

For any infectious conjunctivitis, you should not touch your eyes with your hands, and it is also important for patients to strictly observe the rules of personal hygiene, use only their own towel and wash their hands thoroughly to prevent infection of other family members.

Conjunctivitis caused by toxic substances, develop when chemically aggressive compounds get into the eye.
Main symptom – pain and irritation in the eye, especially when looking up or down. This is the only type of conjunctivitis that can be accompanied by severe pain.

Allergic conjunctivitis occurs upon contact with an allergen in people with hypersensitivity. With this pathology, patients experience severe itching in the eyes and watery eyes. Minor swelling of the eyelids is also common. The main method of treatment is to stop contact with the allergen. In addition, antihistamines are used in the treatment of allergic conjunctivitis ( suprastin) in the form of eye drops or tablets. Drops of artificial tears also help reduce discomfort. In more complex cases, non-steroidal and steroidal anti-inflammatory drugs are used.

Dry eye syndrome

Computer syndrome or “dry eye” syndrome is caused by a lack of hydration of the conjunctiva and a tense state of the visual system, which is caused by static long-term work at a computer at a fixed close distance. In this case, the frequency of blinking decreases several times, and the surface of the cornea dries out, since the tear film is renewed much less frequently.

As a result, the following symptoms occur:

burning, dryness, discomfort and pain in the eyes;
slowdown or stagnation of necessary metabolic processes in the eye structures;
fatigue and redness of the eyes;
decreased visual acuity;
sensation of a foreign body in the eyes;
headache.

The time after which the patient notices characteristic complaints is purely individual and often depends on concomitant eye diseases ( for example, myopia) or vegetative-vascular dystonia.

Prevention of computer vision syndrome includes:

mandatory breaks from work;
correct selection of glasses or contact lenses;
correct body position ( anatomical chair, distance to the monitor at least 30 cm);
special filters in the monitor and correctly selected technical characteristics;
using drops to relieve dry and tired eyes.

Diseases of the outer shell of the eye (Scleritis)

Scleritis is a group of pathologies characterized by inflammation of the sclera ( outer shell of the eye). The main reasons for the development of this disease: rheumatism, tuberculosis, brucellosis, viral infections. It often manifests itself as severe eye irritation, pain, limited swelling and redness, sometimes with a bluish tint.
When palpated, a sharp pain in the eye is noted. The occurrence of complications leads to a decrease in visual acuity.

In cases of inflammation of the superficial layer of the sclera ( episcleritis) irritation is usually less pronounced, and visual acuity does not suffer. Sometimes the process can spread to the cornea with the development of sclerokeratitis and be complicated by iridocyclitis ( inflammation of the iris), which leads to vitreous opacification, pupillary fusion and secondary glaucoma.

As the disease progresses, the inflammatory processes gradually subside, leaving behind areas of black sclera that can bulge and stretch under the influence of intraocular pressure, causing secondary complications. The process takes a very long time - over many months and sometimes years. Treatment of scleritis includes the use of antibiotics, hormonal drugs, corticosteroids and

In terms of its structure and physiology, the human eye is one of the most complex organs. In this regard, he is susceptible to numerous diseases and defects that can develop during life or be an intrauterine pathology. Among all ophthalmological cases, diseases of the lower and upper eyelids occur in 10%. There are a large number of diseases of this part of the visual apparatus, differing in nature, severity of manifestations and etiology.

Types of diseases

The wide spread of diseases of the eyelid is associated with its anatomical structure. There are a large number of blood vessels inside, the skin is elastic and easily stretched, and the epidermal cells have a loose structure. This leads to the development of diseases even with minor changes in the body and exposure to pathological stimuli. There are several dozen diseases of this part of the visual apparatus, differing in many parameters. However, all diseases of the century can be grouped into several groups based on their causes.

Gland pathologies

Barley (hordeolum). The disease is an inflammation of the Zeiss sebaceous gland or eyelash follicle, which forms a characteristic dense pouch at the edge of the skin of the eyelid. Based on localization, internal (acute) and external barley are distinguished, differing in the location of the tumor and the general clinical picture. The causative agent of the disease is Staphylococcus aureus. The development of the disease is always lightning fast, suppuration occurs for several days, and then can open on its own. To avoid complications, it is recommended to open the stye on an outpatient basis;

The causes of stye on the eye can be found out.

(hailstone). The pathology develops as a result of an acute but painless inflammatory process in the meibomian gland. The disease progresses slowly, but eventually a single or multiple dense thickening is formed with white-yellow contents, which leads to blockage of the gland ducts. In some cases, it resolves without medical intervention, but with prolonged development of the disease, surgical removal of the tumor is required. Do not forget that treatment for adults has different specifics.

Skin diseases of the eyelids

Allergic dermatitis

Allergic contact dermatitis occurs due to exposure to allergens on the epidermis of the eyelid. On average, after 1-3 days, severe swelling, hyperthermia occurs, and skin color changes. If you do not treat with antihistamines in time, angioedema may occur.

Diseases of the eyelid margins

. This is a chronic disease of the eyelid margins that tends to recur. The disease develops as a result of weakened immunity, chronic infections and functional pathologies of the body. The defect is often diagnosed in patients with diabetes mellitus or stomach ulcers. It has several forms that differ in external manifestations - simple blepharitis, scaly, ulcerative, angular and demodectic;

How to treat demodicosis of the eyelids, look in.

Actinomycosis (eyelid fungus)

This is a lesion of the eyelids due to infection with radiant fungus. Normally, it is found in small quantities in some structural elements of the oral cavity and is a component of tartar and plaque. When the visual apparatus is infected, the skin of the eyelids, tear ducts and cornea are affected. Manifests itself in the form of swelling and thickening near the corners of the eyes. The neoplasm is a granuloma that grows and becomes necrotic for a long time. Treatment of the disease is always lengthy and often leads to relapses.

Deformations and abnormalities of the eyelids

If abnormalities in the development of the eyelid of any form are detected in an infant, it is recommended to undergo surgery as quickly as possible, since the development of the disease in most cases leads to complications.

Diagnostic methods

There are many eyelid diseases that have a similar clinical picture. To make a correct diagnosis, proper selection of research methods is of great importance.

Visual examination followed by determination of visual acuity and measurement of intraocular pressure;
Diagnostics of refraction;
Study of the functions of the muscles of the visual apparatus;
Ophthalmoscopy and exophthalmometry;
Clinical analysis of urine and blood;
Microscopic analysis and corneas;
Fundus angiography;
Additional auxiliary tests are x-ray, MRI and CT scan of the brain.

Treatment of eyelid diseases is selected depending on the clinical case and is always aimed at eliminating the original disease, rather than external symptoms. This could be antibacterial or antiviral, antifungal therapy, surgery, or taking antihistamines.

Since the eyes are the first thing people pay attention to when communicating with each other, eyelid diseases are always visible and attract attention. On the one hand, this is unpleasant, as it carries a cosmetic disadvantage, but on the other hand, it allows you to quickly detect eyelid diseases.

Congenital pathologies

The formation of the eyelids begins at a six-month-old embryo and ends only at the age of ten. Unfortunately, certain diseases suffered by a pregnant woman or genetic disorders can cause a defect in the formation of these supporting structures of the eye.

Cryptophthalmos in combination with ablepharia– a malformation of the eyeball and the division of the skin flap over it into the upper and lower eyelids. In this case, there are no eyelashes and eyebrows, glands, cartilage and the inner layer of the conjunctiva. It is impossible to cure this disease. For cosmetic purposes, an operation is performed to separate the eyelids and form the palpebral fissure. An underdeveloped eyeball must be removed, as it can become a source of tumor formation.

Coloboma - from the Latin "mutilation" - is a painless defect that looks like a cut on the edge of the eyelid. It can be barely noticeable, or it can cover a significant part of the eyelid. The notch has the shape of a triangle, the base of which is directed towards the ciliated edge. With a large defect, connective tissue threads stretch from the apex of the triangle to the cornea, making it difficult to move the eye.

As a rule, impaired formation of the visual organs is combined with other similar defects - cleft lip or cleft palate. But often a defect can also occur in an adult in already formed eyelids after injury, tumor, or surgery. As with a birth defect, there are no eyelashes or glands in this area.

Ankyloblepharon is a disease of the eyelids, which is characterized by complete or partial fusion of the edges of the upper and lower eyelids.

The pathology may be congenital, or may appear as a result of a facial burn or injury. Surgical separation of adhesions or scar tissue restores the normal anatomy of the organ.

Microblepharon is characterized by a decrease in the size of the eyelid, more in the vertical direction. The size of the skin fold does not allow it to cover the eyeball, so when the eyes are closed, a visible gap or “hare's eye” remains. Treatment is carried out using eyelid surgery.

Blepharophimosis. This is a decrease in the horizontal size of the palpebral fissure due to short eyelids or their fusion at the outer corners. This condition creates pressure on the eyeball and disrupts its blood supply. When blepharophimosis is detected, they try to perform surgery to enlarge the palpebral fissure as early as possible.

Epicanthus. This appearance of the eyelid can hardly be called a pathology, since this is a normal condition for people of the Mongoloid race, although unusual for Europeans. The epicanthus looks like a fold of skin covering the lacrimal sac at the inner corner of the eye. It can increase due to the large amount of subcutaneous fatty tissue, so with age, when this layer becomes thinner, the epicanthus can also decrease.

Displacement of the usual position

Ptosis

This is the name for the position of the eyelid, in which it is lowered without the volitional participation of a person. It may be barely visible, or it may cover the eyeball significantly. The phenomenon of blepharoptosis can develop due to improper development or lack of muscles that should raise the eyelid, or a violation of the conduction of nerve impulses from the oculomotor nerve. Neurogenic ptosis, as a rule, is an acquired condition and accompanies diseases of the nervous system (for example, stroke).

If the matter is a violation of innervation, then the following symptoms are additionally observed:

limited eye mobility;
exotropia;
wrinkles on the forehead from trying to compensate for drooping eyelids;
look with head thrown back.

According to the severity of ptosis, three stages are distinguished:

the eyelid from above covers the third part of the pupil;
overlap is 2/3;
The upper eyelid covers the pupil 100%.

Paralysis of the orbicularis oculi muscle impairs the mobility of both eyelids, and the palpebral fissure is displaced from its normal position. This is how lagophthalmos occurs - hare's eye.

In disorders associated with ptosis, the eye may gradually lose its visual function (amblyopia develops), so they try to eliminate the ptosis as early as possible. But surgical treatment is possible only after the age of three, when the palpebral fissure and eyelids are already sufficiently formed.

Blepharoptosis can be corrected surgically

This is a medical term for turning the edge of the eyelid in such a way that the eyelashes become facing the eyeball. Volvulus is usually congenital and is noted either in a small area or along the entire length. If there is a strong twisting of the edge of the eyelid inward, then severe pain occurs from irritation of the cornea by eyelashes. In the future, this is fraught with the formation of ulcers on its surface, as well as dystrophy and keratitis. Such a violation of the normal structure of the eyelid can be congenital or a consequence of a burn, diphtheria, or trachoma. Sometimes episodes of spastic volvulus occur.

A – entropium, B – ectropion

Ectropion

In other words, this is an inversion of the eyelid, in which it ceases to be in close contact with the conjunctiva of the eyeball. Anatomically, inversion is possible only in the lower eyelid. The reasons can be different: inflammatory (conjunctivitis), spasm, neuralgia of the facial nerve, senile atony of the orbicularis muscle, excessive stretching and sagging of the skin, scarring. The exposed conjunctiva is at increased risk of infection and inflammation, and over time it thickens and ulcerates on the surface.

Infectious diseases

Inflammation of the eyelids almost always accompanies eye diseases, since these formations are connected through a common conjunctiva and have a common innervation and blood supply system.

However, the tissue of the eyelids can become inflamed in isolation from eye diseases in humans.

Formation of boils

Most often, various types of staphylococci provoke purulent inflammation of the hair follicle or sebaceous glands. A painful nodule full of purulent contents forms on the eyelid in the area of the eyebrows. Inflammation covers adjacent tissues, they turn red and swell. After some time, a purulent tip appears on the nodule. It can be of different colors - from white to yellow-green. A person feels a pulsation around the boil, local and general body temperature may increase, headache and weakness may appear. When the boil spontaneously breaks out, these symptoms quickly disappear, and scars form in the place of the former abscess. Furunculosis of the century requires the use of antibacterial drugs, since it is a dangerous source of bacteria and their toxins near the brain. When several abscesses accumulate, they speak of a carbuncle of the century. Since their healing also occurs with scarring of necrotic areas, as a result, eversion of the eyelid or its shortening may occur.

Gordelum is similar to a boil, but is localized in the hair follicles of the eyelashes and the adjacent sebaceous glands, and therefore is found on the edge of the eyelid. There is also an internal form of the disease, in which the meibomian glands on the inner surface of the eyelids become inflamed. In any case, the disease is characterized by the formation of a purulent head surrounded by a zone of hyperemia. The edge of the eyelid is swollen and painful.

Since the disease is caused by bacteria (Staphylococcus aureus), treatment is carried out with ophthalmic forms of antibiotics - drops or ointments.

Abscess

This is the name for the melting of tissue in purulent diseases, while the abscess has clear boundaries. This extensive infectious process occurs when penetrating wounds of the eyelids become infected, infection spreads from a boil or barley, or sinus empyema. The eyelid swells significantly, the skin is hot to the touch, the formation is dense and painful. Often the swelling affects the surrounding areas, and the nearest lymph nodes become painful. An abscess may rupture spontaneously. This is a dangerous condition because infection of the retrobulbar space and cerebral sepsis can occur.

Phlegmon

This is an extreme degree of purulent inflammation, which is diffuse in nature. This condition is caused by an increase in the infectious process from boils, barley, insect bites, and lacerations.

The easy formation of phlegmon on the eyelids is facilitated by loose subcutaneous tissue. The symptoms are pronounced. This is pain, skin flushing, fever, chills, the eyelid is dense and hard to the touch. The transition of the inflammatory process to neighboring areas threatens them with sepsis. Medical assistance is required.

Erysipelas of the eyelids

This infection is caused by group A beta-hemolytic streptococcus, but rarely occurs primarily on the eyelids.

Erysipelas on the eyelids usually spreads from the scalp or face

At the site of inflammation, a feeling of itching and burning appears, bright redness with torn edges. This area is painful, the skin is tense and hot to the touch. The disease leaves behind pigmentation, peeling, and dry, dense crusts. The eyelid may remain swollen for a long time due to lymphostasis. The general condition is disturbed: the temperature rises, the head hurts and is dizzy, the lymph nodes are inflamed. Complications of a septic nature are possible - the formation of ulcers, abscesses, and areas of necrosis on the skin. The infection can go further and cause conjunctivitis, keratitis, optic neuritis, periostitis of the orbit, and inflammation of the meninges.

Shingles

This disease, caused by the varicella zoster virus, affects nerve and epithelial skin cells anywhere in the human body. Regarding eyelid disease, we are interested in herpes zoster ophthalmicus, a lesion of the superior branch of the trigeminal nerve. Initially, pinkish spots appear along its course, then bubbles, which, after opening, leave behind scabs. Skin rashes can also be located on the eyelids, causing secondary infection with bacteria or fungi, and causing deformities. But the greatest threat is hidden, of course, inside - shingles is dangerous due to damage to the cornea, retina, postherpetic neuralgia of the oculomotor and optic nerve.

Molluscum contagiosum

Another viral disease that affects the skin of the eyelids. Characteristic is the formation of small nodules that rise slightly above the skin. They are smooth and have a color similar to the color of the skin or a little more pink. When the nodule “ripens”, a small depression appears in the center, and when pressed, a loose whitish rod, similar to wax, emerges from it. These formations are painless and disappear on their own within six months.

The infection is contact, so the disease, having occurred in one eyelid, can spread to the other if they are rubbed or scratched. The tubercles must not be damaged. If touched, the skin area must be disinfected and hands washed with soap. If the contents of the nodule suddenly fall on the eyeball, it can cause keratitis or conjunctivitis.

Actinomycosis

In addition to bacteria and viruses, fungus radiata can cause damage to the eyelids. Usually it is present in the human oral cavity and does not harm him, but when the immune system is weakened, actinomycetes can give rise to the development of the disease. Fungal infection occurs not only of the eyelids, but also of other auxiliary structures of the eye, especially the lacrimal canals. In a humid environment (in the corner of the eye), the fungus is especially active. Here its colony can form, which provokes tissue necrosis and fistulas. Fungi weaken local protective factors, and actinomycosis is often accompanied by a bacterial infection.

This is the name for hardening that occurs as a result of proliferative inflammation at the edge of the eyelid around the meibian glands or cartilaginous framework. The reason for this formation is the obstruction of the mouth of the gland and the retention of its secretion inside.

The chalazion is painless; upon palpation, it is felt as an elastic round formation that is not fused to the skin.

Blockage of the gland is possible due to hypothermia, poor hygiene, decreased immunity, as well as increased production of secretions from these glands.

Under unfavorable conditions, the chalazion can fester, which will lead to pain, swelling, and a local increase in temperature.

This name combines the symptoms that occur with infectious inflammation of the eyelid margin. Having an idea of what causes this inflammation, simple, scaly, ulcerative, angular, meibomian and demodectic blepharitis are distinguished.

It should be noted that this pathology is often a consequence of a disease of the lacrimal organs; it can be provoked by glaucoma, refractive errors and non-ophthalmological diseases - diabetes mellitus, gastrointestinal pathologies.

In the simple form, the edge of the eyelid thickens, swelling and redness are visible. The sebaceous glands and cartilage are inflamed, itching and irritation are present.

The scaly form gets its name from the yellowish plates that form on the skin, similar to dandruff. When they leave, red, inflamed skin is exposed, it is very vulnerable and brings painful itching. Symptoms include light intolerance, pain from wind and dust.

Acute pain is inherent in ulcerative blepharitis, as ulcers form at the base of the eyelashes. From time to time, crusts grow on them, which, when removed, reopen the ulcers; blood and pus may ooze. In places of ulceration, eyelashes stop growing (trichiasis), and eyelid eversion occurs. The infectious process with the formation of ulcers can spread to the conjunctiva.

Specific pathogens cause special types of blepharitis.

Diplobacillus Morax-Axenfeld is the cause of angular (angular) inflammation of the eyelids. Under its influence, the skin in the corner of the eye becomes covered with crusts and cracks, which causes pain and discomfort. The disease can develop into keratitis before the eyes.

Allergy

The eyes are susceptible to immunological reactions called allergic conjunctivitis. Triggers can be infectious agents, medications or chemicals, cosmetics, dust, pollen, animal hair, food.

The eyelids with allergic conjunctivitis almost always swell. Spring catarrh has a particularly vivid picture. On the inside, the conjunctiva of the eyelid acquires a bumpy surface due to hypertrophy of the papillae to gigantic sizes; when the eyelids close, a feeling of a foreign body occurs in the eye.

Also, damage to the eyelids, such as hyperpapillary conjunctivitis (with enlargement of the papillae), occurs when wearing contact lenses or prosthetic eyes for a long time. The conjunctiva reacts violently to protein deposits that accumulate on optical instruments.

Swelling of the eyelids can occur in the absence of direct contact with allergens, but as part of the general reaction of the body, which is manifested by Quincke's edema.

The eyelids, cheeks, mucous membranes of the nasopharynx, and genitals have loose subcutaneous tissue, so diffuse swelling forms in these places. Angioedema of the eyelids forms in response to insect bites, medications and food to which the body has previously become sensitized. The swelling is pronounced and can completely block the palpebral fissure. Help consists of using antihistamines and cold compresses. You should be aware of the seasonal nature of some allergies and, if possible, desensitize in advance.