• dermoid
• papilloma
• hydrocystoma
• pyogenic granuloma
• xanthelasma
• keratoacanthoma
• squamous cell cancer
• basal cell cancer
• sebaceous cell cancer
• malignant melonoma

• cause- epithelial hyperplasia
• treatment
  • remove at base of papilloma
    • usually a thin stalk at dermal-epidermal junction
  • benign- remove only if they are bothersome to the patient

• def.- cystic mass on eyelid margin or at lateral canthus
• treatment- excision requires removing entire cyst or recurrence can occur

• characteristics
  • not pyogenic
  • not granuloma
  • inflammatory
• treatment
  • excise if bothersome to patient
  • small ones can resolve with topical treatment

• cause
  • either normal or elevated cholesterol
  • sometimes seen in people with familial hypercholesterolemia
• often recur after excision

• characteristics- large, relatively fast growing mass on/near eyelid
• comp.
  • keratin filled crater with rolled edges
• treatment- usually excise due to size
• prognosis
  • benign
  • could be very low grade squamous cell cancer

• appearance
  • flat lesion
  • may have ulceration at center
• cause- UV related, especially in elderly light skined patients
• treatment- surgical excision with attention to margins
• loc.- usually lower eyelid

NUMBER 2 eyelid malignance

• cause- UV related
• loc.- usually lower eyelid
• appearance
  • firm pearly lesions
  • can have central ulceration
  • telangiestasia
  • lash loss
• treatment- complete excision with attention to margins

MOST COMMON eyelid malignancy

• appearance
  • tan, black, or gray nodule with irregular margins
• prognosis- related to depth of invasion
• treatment- wide surgical incision with systemic therapy

globe displaced forward

globe displaced back (sunken)

• thyroid eye disease
• sarcoidosis
• orbital mass
• orbital infection
• vascular anomalies
• vasculitis

• orbital decompression
  • fracture
  • surgical
• metastatic breast cancer sclerosing mass

• treatment
  • IV antibiotics
  • CBC and CAT scan of orbits and sinus
• definition- infection within orbital cavity
• appearance
  • area of redness limited by orbital septum (connects to bone, subQ)
  • chemotic conjunctiva
• course- usually follows ethmoid sinus (can occur after frontal, maxillary, or sphenoid sinusitis)

• decrease vision
• pain
• headache
• diplopia
• bulging eye (proptosis)
• lid swelling
• fever

• location
  • ant. to orbital septum
  • can spread to cheek, forehead
  • limited to superficial periorbital tissue (NOT conjunctiva)
  • less serious than orbital cellulitis
• symptoms
  • normal vision and motility (no pupillary defects)
  • eye swelling with pain
  • orbital and sinus CT normal
  • conjunctiva normal
• cause- can follow:
  • periorbital trauma
  • skin infection
  • sinus diagnosis
• treatment
  • systemic antibiotics (depends on severity)
  • CBC, blood/wound cultures

• def.- autoimmune disease causing enlargment of muscle belly, sparing tendon
• pathology
  • acute- lymphocytic infiltrate
  • late- progressive fibrosis with muscle replacement

• soft tissue signs
• eyelid retraction
• lid lag
• lagophthalmos
• exophthalmos
• extraocular muscle restriction
• optic N. compression

Range from dryness to optic neuropathy.

• remove at slit lamp
• topical antibiotics until surface heals
  • remember, if organic compound, be worried about fungus

• diplopia
• enophthalmos
• restricted EOM

• def.- medial wall and floor often both broken
  • may actually protect globe from rupture
• cause- usually blunt trauma
• treatment
  • thin sliced CT
  • repair depends on symptoms

• cause- trauma (sharp object)
• treatment- careful repair required to prevent lid margin notching or problems with tearing

• treatment- lateral canthotomy and cantholysis ASAP
• prognosis
  • risk for visual loss due to compartment syndrome
  • often very high eye pressure due to compression
• definition- blood behind the globe
• cause- usually trauma

• definition- ruptured globe (foreign body entered somewhere)
• treatment- surgery to remove foreign body

• cause- trauma
• prognosis- visual outcome depends on location and severity of rupture
• treatment
  • requires surgery
  • goal is to reform globe