II Disorders of the lids, lacrimal drainage apparatus, adnexae and orbit
Essential topics/experience:
To have become familiar with the following:

i. Abnormal lid position: including assessment of ectropion, entropion, ptosis, trichiasis,
lagophthalmos and exposure.

ii. Abnormal lid swelling: including chalazion, stye, retention cysts, papilloma and basal cell

iii. The watering eye: including the distinction between excessive lacrimation and epiphora;
blepharitis; recognition and investigation of nasolacrimal obstruction.

iv. Orbital swelling: including dysthyroid eye disease, distinguishing intraconal from
extraconal space-occupying lesions, orbital cellulitis, recognition of compressive optic

v. Liaison: with neurosurgeons, ENT, endocrinologists, prosthetic service.

Practical skills:
To have undertaken (under supervision until proficient) the following:

i. Use of exophthalmometer.

ii. Syringing and probing.

iii. Incision and curettage for chalazion.

iv. Wedge biopsy and removal of papilloma etc.

v. Tarsorrhaphy.

vi. Electrolysis/cryotherapy for trichiasis.

vii. Surgery for involutional ectropion/entropion.

Background theory/principles:
To have gained an awareness of the following:

i. Sebaceous carcinoma of lid and squamous cell carcinoma.

ii. Cicatricial malposition of the lids.

iii. Management of ptosis and blepharospasm.

iv. Canaliculus repair.

v. Dacryocystorhinostomy.

vi. Orbital and lacrimal tumours and their treatment.

vii. Inflammatory orbital and lacrimal diseases and their treatment.

viii. Paranasal sinus disease.

ix. Use of radiographs, MRI, CT scan.

x. Enucleation, evisceration and fitting of prosthesis.

xi. Exenteration.

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