Echymosis, the color of the eyelid changes as a result of blood extravatation after trauma.
Ectropion, is turning outward of the eyelids, could be found in elderly, paralise
of the muscles, cikatriks and other.
Entropion, turning inward of the eyelids.In Trachomas patient the entropion usually happen in upper eyelids. Entropion could also happen due to parese
of the muscles, cikatriks and senile condition.
Lagoftalmos: inabillity to close the eyelids completely.
Redness, inflamation, squama, tumour Merah, radang, keropeng skuama, tumor.
Pseudoptosis, difficulties to open the eyelids as if it is drooping. Happen on
enophthalmos, phtisis bulbi, chalazion or the other eyelids tumour, eyelids edema and blepharochalazis.
Ptosis, drooping eyelids. Usually happen in elderly with history of intraocular
surgery, Myasthenia gravis, Horner Syndrome, N III palsy, botulinum toxin injection
Cikatriks, scar on the eyelids
Trikiasis, silia atau bulu mata tumbuh salah arah sehingga dapat merusak
kornea. Trikiasis dapat disebabkan blefaritis dan entropion.
Xantelasma, penimbunan deposit berwarna kekuning-kuningan pada kelopak, terutama nasal atas dan bawah. Xantelasma biasanya dihubungkan
dengan hiperlipidemia dan dapat tanpa hiperlipidemia seperti pada histiosis dan retikulohistositoma.
Abnormality of lower eyelids:
Similar with upper eyelids Swollen of lacrimal sac, redness and sometimes pus came out when it be
pushed. Madarosis.
Inerpalpebral Fissure
Normal Narrow or small, if there is eyelids edema, blepharitis, ptosis, pseudoptosis,
blepharophymosis Wide or bigger, happened in hyperthyroid or intraocular tumour.
Eyelids margin
Complete cilia Trichiasis
Meibomian gland punctum secretion Redness, pain and ulceration
2. Conjunctiva Upper Tarsal Conjunctiva
Can be checked by eversion the upper eyelids using finger or cotton tip applicator. Abnormality of the conjunctiva:
Cobble stone follicles, deposite of macrophages and lymphoid cells under the conjunctiva. Dome shaped appearance, about 1 mm. Most follicles can be
seen in forniks area because in this area consist of a lot of lymphoid tissues. Membrane, inflammatory cells beyond the conjunctiva that will be bleed
iwhen excised. This membrane usually appears like mass surrounding tarsal or bulbar conjunctiva. It is consists of necrotic tissues, penetrated to the
deeper layer and greyish, usually can be found in patient with bacteria conjunctivitis or rarely happened on viral conjunctivitis.
Pseudomembrane, membranes that not get bleed if excised. Happened in ocular pemphygoid and Steven Johnson Syndrome.
Udayana University Faculty of Medicine, DME
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Papillae, tiny dome shaped nodule that consist of hyperemic central core blood vessels of the conjunctiva that protrude up and perpendicular to the
tarsal plate surrounded by edema and inflammatory cells Giant Papillae, polygonal shaped, flat and coukd be found in vernal
conjunctivitis, superior limbic keratitis, and iatrogenic conjunctivitis. Cicatriks, in trachoma usually the direction of the cicatriks is parallel with
eyelids margin. Simblepharon, stickyness of tarsal and bulbar conjunctiva and kornea. Can
be found in chemical trauma or Steven Johnson Syndromes Hordeolum or Stye
Chalazion.
Inferior tarsal conjunctiva Konjungtiva tarsal inferior The abnormalities could be:
Cobble stone follicles. Papil.
cicatriks Hordeolum or Stye.
Chalazion.
Bulbar conjunctiva The abnormalities could be:
Discharge Conjunctival Injection, vasodilatation of superior conjunctival arteries
Cilliary Injection, vasodilatation of pericorneal arteries or anterior cilliaris arteries.
Episcleral injection, vasodilatation of episcleral vessels Subconjunctival bleeding.
Flickten, inflammatory surrounded with neovascularization on conjunctiva Simblepharon.
Degeneration plaque Pinguecula, conjunctival degeneration plaque in palpebral fissure area,
triangular shape in nasal and temporal cornea Pterygium, proliferation of fibrous tissues process with neovascularization on
conjunctiva, triangular shape with the apeks toward the cornea Pseudopterygium.
Flickten, inflammatory cells and neovascularization on the cornea.
3. Sclera