Ophthalmology: Eyelid and Conjunctiva Abnormalities

Abnormal Eyelid Position

• Ptosis can be a sign of Horner's syndrome (subtle ptosis with miosis) and oculomotor nerve palsy (partial to complete ptosis with 'down and out' eye position and enlarged pupil)

Lids & Lashes

• Normal position: 2mm below top of iris and 2mm below bottom edge of iris
• Abnormal findings:
  • Lesions
  • Crusting
  • Redness
  • Swelling/bruising
  • Lacerations
  • Abnormal lid position

Conjunctiva

• Covers the inside of eyelids and sclera, but not the cornea; it's vascular
• Normal: translucent, flat, and sclera visible beneath
• Abnormal findings:
  • Chemosis (edema)
  • Discharge
  • Subconjunctival hemorrhage
  • Lacerations
  • Lesions

Cornea

• A vascular circular 'window' of the eye
• Normal: clear, bright, and smooth surface
• Abnormal findings:
  • Cloudy (iris may be difficult to see)
  • Scarring (milky line, localized opacity)
  • Foreign body
  • Rust ring
  • Abscess
  • Laceration

Iris

• Normal: similar appearance between eyes
• Be aware of colored contact lenses (diameter)
• Abnormal findings:
  • Lesions
  • Tears
  • Lacerations
  • Prolapsed

Crystalline Lens

• Lies behind the iris, seen through the pupil
• Normal: bright, clear, and transparent with a red reflex
• Abnormal findings:
  • Dull or absent red reflex
  • White pupil
  • Shadows in red reflex

Anterior Chamber

• Space between posterior cornea and iris, filled with aqueous fluid
• Normal: clear, bright, and deep
• Abnormal findings:
  • Flat
  • Shallow
  • Anterior chamber Intraocular Lens (IOL)

Dry Eye

• No additional information provided