insufficiency of eyelid closure
Introduction
Brief introduction of eyelid closure Incomplete closure of the eyelid means that the upper and lower eyelids cannot be completely closed, resulting in partial eyeball exposure, also known as rabbit eye. The most common cause of eyelid regurgitation is facial nerve palsy, followed by scarring valgus, and the ratio of eyelid volume to eyeball size is imbalanced. Eyelid regurgitation can occur when general anesthesia or severe coma. When a few normal people sleep, there is a gap in the cleft palate, but the cornea is not exposed, called the physiological rabbit eye. Conjunctival congestion, dryness, hypertrophy and hyperkeratosis are caused by incomplete closure of the eyelids. In severe cases, due to corneal exposure, the surface is moist and dry without tears, leading to exposed keratitis. Usually, according to the clinical manifestations of the eye, it is not difficult to diagnose the closure of the eyelid. In terms of treatment, first of all, the cause is mild, conservative, and severe if necessary. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: eyelid skin flaccidity
Cause
Causes of eyelid closure
Acquired disease factors (25%):
Various factors that cause severe valgus, facial nerve palsy, and loss of function of the orbicularis muscle.
Congenital genetic factors (25%):
Congenital poor development, genetic mutations may lead to congenital eyelid defects.
Physiological factors (25%):
Increased eyeballs or increased sputum content, such as congenital glaucoma, corneal staphyloma, intraorbital inflammation, intraorbital tumors and hyperthyroidism.
Environmental factors (25%):
In patients with general anesthesia, coma or failure, the cornea loses consciousness, the blink reflex disappears, and functional paralysis can also occur.
Prevention
Eyelid occlusion prevention
Generally, eye correction surgery is performed. First, the diaphragm is strengthened, the orbicularis muscle is lifted, and the excess skin is finally removed. However, some doctors mistakenly correct the correction of the bags under the eyes and neglect the tightening of the diaphragm and the orbicularis muscle. If the amount of skin removed is appropriate, and the diaphragm and the orbicularis muscle are not treated, the eye bags will recur quickly. If the skin is removed too much, it will be suitable for valgus valgus. In recent years, many scholars have agreed that the corrective operation of the eye bags, the strengthening of the septum, and the lifting of the orbicularis muscles are more important than the skin removal.
Complication
Eyelid closure incomplete complications Complications, eyelid flaccid disorder, ptosis
Eyelid relaxation: blepharochalasis syndrome, also known as dermatolysis palpebrarum, atrophic eyelid ptosis (ptosis atrophica), is a rare eyelid disease characterized by recurrent episodes of eyelid edema in adolescents. The skin of the eyelids becomes thinner, the elasticity disappears, the wrinkles increase, and the color changes, which can be accompanied by clinical manifestations such as lacrimal gland prolapse, ptosis and shortening of the cleft palate. In 1807, Beer first described the disease. In 1896, Fuchs called it eyelid retardation. Because the syndrome affects the appearance of the eyelids, it is the main reason for patients to require treatment. The understanding of their clinical manifestations and pathogenesis can help to adopt appropriate methods for treatment.
Eyelid relaxation and upper lip thickening : characterized by loose eyelids and progressive thickening of the upper lip, it is called eyelid relaxation-upper lip hypertrophy syndrome, and some patients have goiter, also known as eye-mouth-thyroid syndrome. From the early onset, the eyelid edema began, after repeated episodes of eyelid skin relaxation, wrinkling, accompanied by telangiectasia, severe eyelid ptosis. From the infants and young children, the lips are repeatedly swollen, and the lips become fibrotic due to inflammation and become thicker into lips. Simple thyroid gland and swelling occur during puberty.
Upper eyelid thickening and relaxation : The head of patients with thick skin periosteal disease is a retrograde cranium, especially the upper eyelids are thick and slack, the ears and lips are also thick, especially large, and the skin of the hands and feet is also hypertrophic. The bones of the extremities and the phalanx are hypertrophied, the fingers and toes are sick, and the sacs and knee joints are effusion. The patient has pain in his limbs and his movements are awkward.
Eyelid drooping: also known as "hanging down." Due to insufficiency or disappearance of the levator palpebral function, or some or all of the upper jaw can not be lifted, the upper jaw is in a drooping position. Divided into complete and partial, monocular or binocular, congenital and acquired, true and false. If congenital, check whether: 1 simple ptosis (lifting or disappearing of the diaphragm function); 2 ptosis with upper rectus muscle function weakened; 3 ptosis with other ankle deformities, such as internal hemorrhoids Skin, etc.; 4 ptosis combined with (Marcus-Gunn) mandibular blinking movement phenomenon. If the nature is acquired, check whether: 1 traumatic eyelid or craniocerebral injury, or cervical sympathetic nerve injury; 2 disease such as myasthenia gravis; 3 mechanical such as trachoma sacral infiltration, or loss of support force of eyelids, If there is no eyeball. When there is suspected myasthenia gravis, it can be used as a test for neostigmine. When it is suspected of sympathetic drooping, it can be used as a test for hydroxyamphetamine.
Symptom
Eyelid closure incomplete symptoms Common symptoms Conjunctiva tears area gray... Condyloma acuminata conjunctiva conjunctival hyperemia corneal ulcer
The lighter can close the eye with force, and the eyeball is turned up during sleep (Bell phenomenon), only the lower bulbar membrane is exposed, so it will not cause serious damage; in the heavier, the cornea is exposed for a long time, the conjunctival hyperemia is thick, and the membrane is dry and turbid. The epithelium is shed and corneal ulcers appear. Exposure keratitis (exposure keratitis), severe cases can be blind. In addition, because the tears can not contact the tear lake, tears.
Examine
Eyelid incomplete examination
General examination of the eye, including eye appendages and anterior segment examinations.
Diagnosis
Diagnosis of eyelid closure
diagnosis
According to the clinical manifestations of the eye, it can be clearly diagnosed.
Differential diagnosis
The eyelids are slack, the eyelids are loose and the upper lip is thickened, the upper eyelids are thickened and slack, and the eyelids are drooping.
