The eyelid margin is drooping in a horizontal "S" shape

Introduction As a result of acute sacral lacrimal gland disease, it is characterized by a transverse "S" shape sag, which is a clinical manifestation of acute sacral lacrimal gland inflammation. Acute lacrimal gland inflammation is limited to the glandular or glandular glands, and even inflammation at the same time, local pain and tears, 1/3 of the upper iliac crest, redness and swelling, ptosis (inflammation), accompanied by high edema of the eyelids, if the upper eyelid is raised, When the eyeball is turned down, the swell of the lacrimal gland can be seen. In severe cases, the eyeball can be displaced downwards. The lymph nodes in the ear are swollen and tender. Usually, the inflammation subsides after 1 to 2 weeks. The purulent can pierce the temporary fistula. It has also changed into subacute or chronic. Acute axillary lacrimal gland: redness, swelling, pain, tearing discomfort on the lateral side of the upper eyelid, sag in the transverse "S" shape, swelling can spread to the sputum, cheeks, swollen lymph nodes in the ear, tenderness, sputum And solid mass, there is tenderness, no adhesion to the sacral wall and sacral margin, conjunctival congestion and edema on the sacral conjunctiva, lacrimal gland tissue congestion, mucus-like secretions, may be associated with fever, headache, general malaise, if Early appropriate anti-infective treatment, more than 1 to 2 weeks of inflammation subsided, and some sub-acute, only 1 to 2 months to resolve, a small amount of suppuration from the upper conjunctiva perforation, pus discharge into the conjunctival sac or temporarily formed fistula, It can heal in 2 to 3 weeks.

Cause

Acute lacrimal gland inflammation is caused by various infectious diseases, such as mumps, influenza, typhoid fever, pneumonia, acute pharyngitis, etc. It can also be the result of the spread of inflammation around the tissue. In addition, there are also unexplained reasons, generally referred to as primary, bilateral or unilateral onset, the lacrimal gland of the palate is more susceptible to the lacrimal gland.

Common pathogens are: Staphylococcus, Streptococcus pneumoniae, etc., a few cases are caused by viruses. Staphylococcus is a group of Gram-positive cocci, which are often clustered into bunches of grapes. Most are non-pathogenic, and a few can cause disease. Staphylococcus is the most common pyogenic cocci, which is an important source of cross-infection in hospitals. The diameter of the cells is about 0.8m, small spherical, but in the juvenile culture of liquid medium, it is often dispersed, and the bacterial cells are present separately. Staphylococcus is found in the concentrates by Koch (R. Koch. 1878), Pasteur (L. Pasteur, 1880) and Augston (A. Og-ston, 1881), but FJ Rosenbach (1884) was trained and studied in detail. There are many physiologic properties common to E. coli-coli-aerog-enesgroup and lactic acid bacteria, but their toxicity is very strong. Transplantation in animal blood vessels can cause abscesses in animals. Shows severe symptoms and even death. However, species similar to human skin abscess are not easily found in animals, and very few have similar symptoms in apes and rabbits.

The bacteria of the genus Streptococcus pneumoniae are round, and often form short chains in the sputum and pus, without flagella; capsules can be produced in humans and animals. The bacteria is weak against temperature and is killed when heated at 52-56 ° C for 15 to 20 minutes; it has strong resistance to drying and can survive for 1 to 2 months in the dark place. The bacteria are widely distributed in nature and often live in the nasal cavity of normal people. Most of them are not pathogenic or pathogenic, and a few have strong pathogenicity. Whether it can cause disease and the capsule is closely related, because the capsule can resist the phagocytosis of phagocytic cells in the body and multiply, causing disease. The key to pneumococcal infection is to develop good hygiene practices and maintain environmental hygiene. Vaccination may be given to vulnerable children and the elderly if necessary. The polysaccharide vaccine prepared by the bacterial capsular polysaccharide is used for prevention, and the effect is good. Sulfonamides and penicillins are effective in the treatment of diseases such as pneumonia.

an examination

Related inspection

Eye and sacral area CT examination blood test

According to the patient's medical history and clinical manifestations, combined with local signs, especially acute lacrimal gland inflammation, diagnosis is not difficult. The diagnosis of acute lacrimal gland inflammation may involve the temporal lobe or temporal lobe of the lacrimal gland separately or at the same time. It is characterized by local swelling and pain in the upper part of the palate. The upper edema is S-shaped and deformed, and the lymph nodes in the ear are swollen. Palpation can be phlegm and mass, tenderness, conjunctival congestion, edema, and viscous secretions. When you mention the upper jaw, you can see that the lacrimal gland is swollen and bloody. The course of acute liquid adenitis is usually short-lived and can be relieved by itself, but an abscess can also form. The specific diagnosis is based on:

1. Acute onset, mostly unilateral, local redness, pain, tenderness, accompanied by inflammatory ptosis, adjacent conjunctival edema and congestion. When the lacrimal gland is inflamed, it may be accompanied by symptoms such as displacement of the eyeball inward and downward, restricted movement, and diplopia.

2. The swollen lacrimal gland can be touched under the upper edge of the upper edge of the iliac crest. When the upper eyelid is lifted downward, the swollen lacrimal gland can be seen to bulge from the outer upper conjunctiva.

3. The lymph nodes are swollen before the ear, the body temperature rises, and the body is unwell.

Differential diagnosis

Eyelid malformation: Eyelid deformity is caused by trauma, infection, tumor resection and other reasons. After scar contracture, it can cause abnormality of eyelid axillary shape, eyelid valgus and insufficiency.

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.

Dropping of the eyelids: drooping of the eyelids, also known as sagging of the upper eyelids, means that part or all of the muscle function of lifting the upper eyelids is lost, so that the upper jaw is partially or completely unable to be lifted. When the eyes are looking straight ahead, the upper eyelid covers the upper edge of the cornea more than 2 mm. . The muscles of the upper jaw are lifted on the diaphragm and Müler's muscle. The upper jaw is supported by the oculomotor nerve. The Müler's muscle is innervated by the cervical sympathetic nerve. When the two muscles are incomplete or lost, they will appear. The eyelids are drooping. The upper sag is lighter and can cover part of the pupil. In severe cases, all the pupils are covered, which not only hinders the appearance, but also affects vision. In order to overcome the visual impairment, the patient often tightens the frontal muscles and wrinkles the eyebrows to raise the position of the upper jaw. In severe cases, you must look up and even use your fingers to raise your upper jaw to see things.

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