Eyelid Diseases

This chapter reviews eyelid malpositions, benign and malignant tumors, infections, and inflammatory diseases of the eyelid. Eyelid lesions can originate in any layer or structure within the eyelid and eyelid adnexa. Benign tumors of the eyelid can often be diagnosed based on their characteristic appearance. A biopsy should be performed if an eyelid lesion is not easily diagnosed based on clinical appearance. Blepharitis and meibomitis are very common disorders. Despite their prevalence, these diseases are often overlooked and misdiagnosed. Meibomian gland dysfunction is a major cause of evaporative dry eye and can occur along with aqueous deficient dry eye. Bacteria, fungi, viruses, and parasites can cause infection of the eyelids in different locations, anterior, posterior, angular, which can have different courses, acute, intermediate, or chronic. This chapter also contains photos with a rare disorder, Urbach-Wiethe disease, demonstrating the lesions of lipoid proteinosis at the lower and upper eyelids.

Choroidal Thickness in Lipoid Proteinosis

Purpose: To assess choroidal thickness in patients with lipoid proteinosis versus healthy subjects using enhanced depth imaging optical coherence tomography. Methods: 40 eyes of 20 patients and the same number of age and sex-matched healthy individuals were enrolled. Comprehensive ocular examinations including measurement of best-corrected visual acuity, spherical equivalent values of refractive errors, and axial length were performed. Choroidal thickness at three points (subfoveal, 500 µm nasal and temporal regions) were measured. Results: The mean age was 15,68 ± 5,98 years in the patient group and 16,48 ± 5,69 years in the control group. Mean choroidal thickness was statistically significantly thicker at each point in patients with lipoid proteinosis compared to the healthy controls: subfoveal, temporal and nasal choroidal thickness measurements were 414,13 ± 53.88, 359.97 ± 64.75, 322.10 ± 56.74 in the study group; 341.60 ± 42.01, 329.55 ± 41.30, 295.44 ± 43.07 in the control group, respectively ( P < 0.05). Conclusion: Patients with lipoid proteinosis have thicker choroid compared to control eyes. Hyalin deposition and ensuing potential inflammation in the disease process may explain this finding.