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What would cause a single white eyelash?

What would cause a single white eyelash?


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I couldn't find a paper who could give me the explanation. Unfortunately, according to my search, it seems there are not many reported case, particularly for the younger population (<30). Would stress cause this?


  1. What Causes Hair to Have Colour and How is Colour Lost?

The colour of hair is due to the presence of melanin, which may be found as eumelanin or pheomelanin. Melanin is produced by melanocytes and is transported to keratinocytes. The hair then grows out from a root at the bottom of the hair follicle. A hair without melanin is a grey hair. The exact specifics of how hairs go grey is quite complex and poorly understood.
The growth and pigmentation of hair grows are both regulated by many factors, including genes such as MC1R and DLX3. This provides some explanation why people of particular ethnicities or families can go grey at different times - their genetic makeup changes how quickly they go grey.
Another factor affecting hair pigmentation is reactive oxygen species (ROS). The generation of ROS (oxidative stress) has been shown to have a role in the greying of hair.. Moreover, ROS are generated by smoking, which could lead to premature greying.
Other factors that have been found to be associated with premature hair greying include UV light, vitamin B12, iron, copper, ferritin, calcium and vitamin D3 (source).

  1. What Would Make an Individual Eyelash go Grey?

As far as I know, the regulation of eyelash growth and pigmentation is very similar to that of hair on the scalp.
Given that the regulation of hair pigmentation is controlled by genetic factors, it could be that there is a change in the function of the genes at that particular hair follicle. This could possibly involve mutations which change signaling pathways, melanin generation, etc. such that melanin is no longer transported into the hair.
There could also be an extrinsic (outside of the body) factor which has locally stopped melanin production. Perhaps at some point, there was an elevated level of ROS or UV light at that particular hair follicle. This could have introduced mutations in the genes, or could have changed how the hair was pigmented. Alternatively, there could be death of melanocytes in that specific area, which could stop the generation of melanin. There could also be a local change in the levels of the factors associated with greying (e.g. a local vitamin B12 deficiency).

  1. Does Stress Cause Premature Greying?

Surprisingly, despite common knowledge telling us that hair makes us go grey, there is conflicting evidence about this. Stress has been shown to make us go bald earlier but whether it also makes us go grey is not conclusively known. But given that stress has a clear negative impact on health, it's probably best not to be too stressed regardless.


10 Symptoms of Blepharitis, a Bizarre Condition That Can Affect Your Eyes

When you wake up in the morning, you should be able to open your eyes. That’s the bare minimum of having eyes, really. Unfortunately, if you have blepharitis, your eyes can act up in such a way that even this basic function is hard to do.

Blepharitis is a funky eyelid inflammation that can happen for a variety of reasons, like a bacterial infection on your eyelids, an allergic reaction to your makeup, or a malfunctioning of the glands that pump oil into your tear film to help your eyes stay moisturized, according to the Mayo Clinic.

Doctors split blepharitis into two categories: anterior blepharitis, which happens at the outside front edge of your eyelid where your eyelashes attach, and posterior blepharitis, which affects the interior edge of your eyelid that touches your eyeball. Anterior blepharitis usually occurs because of bacteria called Staphylococcal blepharitis or because dandruff from your scalp and eyebrows inflames your eyelids, per the American Optometric Association. Posterior blepharitis can happen when your Meibomian glands, which are the ones that pump oil into your tear film, get out of whack and create a good environment for bacterial growth. It can also happen due to dermatological conditions like rosacea and scalp dandruff.

The good news is that blepharitis is manageable and doesn’t permanently damage vision or anything like that, but it is really annoying. Here are the major blepharitis symptoms you should know.

Welcome to planet Earth, where everyone has some eye boogers in the morning. This happens because, as part of your normal tear function to keep your eyes lubricated, your eyes build up a mucus-based discharge overnight. Since you’re not blinking while you sleep to wash away any excess matter, it gathers in the corners of your eyes, hence that gunky stuff you see in the morning. Blepharitis can take this process to a whole other level.

When you have blepharitis, your Meibomian glands can overproduce oil that ends up drying on your eyelashes, Ann Morrison, O.D., clinical instructor in The Ohio State University College of Optometry, tells SELF. That can result in feeling like your eyes are basically glued shut when you wake up. Even if your case isn’t that severe, you might wind up with a ton of crust accumulating on your eyelashes overnight.

Bacterial overgrowth on your eyelids can cause blepharitis, and sometimes this overgrowth can also make your eyelid skin flake off or look scaly, Dr. Morrison says.

In a pretty unfair catch-22, blepharitis inflammation might make you want to rub your eyes, but that typically just exacerbates eyelid flaking, Mina Massaro-Giordano, M.D., codirector of the Penn Dry Eye & Ocular Surface Center and a professor of clinical ophthalmology at the University of Pennsylvania, tells SELF. “You can get into a vicious cycle,” Dr. Massaro-Giordano says.

Blepharitis can make your eyes so excessively watery that it’s like you watched a string of back-to-back tearjerkers. Since blepharitis causes things like crusting, dead skin, and mucus to develop along your eyelids, that stuff has pretty easy access to your eyes. There, it can irritate your eyeballs, so your eyes might tear up in response, Dr. Massaro-Giordano says.

Dry eye, a common complication of blepharitis, can also be a factor, Dr. Morrison says. If you have dry eye, it means your eyes can’t produce enough tears or produce tears of low quality that can’t keep your eyes moisturized and healthy. Blepharitis can cause this by blocking those Meibomian glands, so your tear film doesn’t have enough oil. Cue a slew of aggravating symptoms like dryness, itchiness, redness, pain, and sensitivity to light. Counterintuitively enough, dry eye can also cause excessive tearing as your eyes work to quench their thirst.

Blepharitis can make your eyes feel all-around terrible. Much like the one of the potential reasons behind watery eyes, all that blepharitis-induced debris can get into your eyes and cause burning or stinging in response to the intrusion, Dr. Morrison says.

Blepharitis doesn’t just mess with how your eyes feel—it can affect their coloring, too. Your eyelids can get red as part of all that inflammation, and your actual eyes can take on a red hue if the blood vessels in your conjunctiva (the mucous membrane on the front of your eyes and the insides of your eyelids) widen due to irritation. This can happen because of blepharitis complications like dry eye or because little skin flakes get into your eyes.

It’s easy to think that puffy, itchy eyes are a sign of allergies. But allergies often cause itching in your actual eyeballs whereas blepharitis can make you want to rub your inflamed, itchy eyelids right off your face.

Blame your Meibomian glands. When these little guys become inflamed, they can produce more natural oils than usual, making your eyelids look like they’re covered in grease, Dr. Morrison says. Not everyone with blepharitis will get this symptom, but if you have oily skin to begin with, your odds may be higher, Dr. Massaro-Giordano says.

Blepharitis can leave you groping for your sunglasses when you normally would be able to handle the light just fine. Usually this happens if you have dry eye along with your blepharitis. Dry eye affects your corneas, which are the clear, dome-shaped outer layers of your eyes, Dr. Morrison says. When your natural tears can’t nourish your corneas properly, your corneas can become irritated, causing light sensitivity.

Chalk this up to general irritation that comes with blepharitis. If something gets in your eye like eyelid skin flakes or eye crust, blinking is a natural reflex to try to get rid of that debris, Dr. Massaro-Giordano says. Your eyes also probably feel dry and gritty, and blinking is your eyes’ normal mechanism to spread moisture across your eyeballs and make it all better, Dr. Morrison says.

This is why it’s so important to get blepharitis taken care of if you have it: Blepharitis can cause your eyelashes to fall out or be “misdirected,” i.e., grow at weird angles when they come back in, Dr. Morrison says. This is because your eyelashes are close to your Meibomian glands, and if those are always inflamed, your eyelashes might fall out as a result, Dr. Massaro-Giordano says. Then, when they grow back, they may not be able to come in straight because of scarring or inflammation. (For the record, Dr. Massaro-Giordano says this is a less common blepharitis symptom than the others on this list, thankfully.)

To deal with symptoms like crusted-over eyes and eyelid flaking, grab a warm, damp washcloth, hold it over your eyelids for a few minutes to loosen up the crusties, and then gently wipe them away, Dr. Massaro-Giordano says. The Mayo Clinic recommends doing this two to four times a day when your blepharitis is acting up, then at least once a day even when it seems to be control. They also suggest following that up by washing each eye with a damp, warm washcloth and a few drops of diluted baby shampoo. (Use a different cloth for each eye, and make sure they’re clean before you do.)

You’ll need to see a doctor for more intensive blepharitis treatment, which can involve infection- and inflammation-fighting drugs or treatment for an underlying condition that’s causing your eyelid problems. They may also decide you need to wash your eyelids in a more specific way based on your particular blepharitis case. Talking to a doctor is really the best way of forcing your blepharitis to see its way out.


Lash Education: Eye Infections

When the eye or surrounding eye area is exposed to certain bacteria or organisms, eye infections can occur. Lash education is vital: as a lash professional, you must educate your clients on the importance of hygiene to keep their beautiful eyes free of infection.

If your client displays any of the following symptoms of an infection, we recommend not proceeding with the service until the client has been treated by a healthcare professional, and symptoms have cleared. However, it is up to you and your best judgment. In some cases, when the symptoms are not contagious, (such as with allergic conjunctivitis,) it can be safe to proceed with written permission from a healthcare professional. (Basically, a doctors note.)

Listed below are the most common types of eye infections and their symptoms. We recommend educating yourself about these, so you are able to spot them, and know when it’s in your and your client’s best interest to advise against performing the service.

1) Lash Education- Allergic Conjunctivitis:

When eyes are exposed to allergens, (such as pets, pollen, dust, mold, etc,) causing eyes to become watery, red and itchy. This is the most commonly occurring among clients, and can be tricky. Although allergies are not contagious from one client to the next, applying lash extensions to already irritated eyes, can worsen the symptoms minimally, or drastically.

2) Lash Education- Blepharitis:

When lash follicles are red and inflamed. This is caused by bad hygiene, allergies, mites, dandruff and certain medications. We recommend not proceeding with the service, as reaction/symptoms are likely to worsen.

3) Lash Education- Conjunctivitis:

An infection which inflames the conjunctiva of the eye, causing the eye to turn pink or in some cases, red. Commonly known as Pink eye, this contagious infection is easily spread. Do not proceed with the service until client is treated, and symptoms have cleared.

4) Lash Education- Demodex:

Parasites found inside pores and hair follicles that cause infection and inflammation. These are Eye Mites. Mites live inside pores and can be hard to spot or distinguish. However, if eyes are irritated or inflamed at all, we recommend not proceeding.

5) Lash Education- Stye:

Bacterial infection of the sebaceous glands, causing a red, painful bump or inflamed area of the eye. Styes can occur when the hair follicle is clogged and irritated. Although not contagious, styes require hot compresses in order to clear up. We recommend not proceeding with the service, until stye has cleared.
It is your job to ensure that your station, tools, and hands are free from bacteria that could spread infection or disease. Remember to never apply lash extensions to clients who show any signs of these infections. We also recommend having all new clients sign a waiver and release form to protect yourself. This form is vital to your lash business, as it is a form of insurance and can protect you from certain liabilities that could occur. It’s always better to be safe than sorry!


What causes eyelashes to thin and shorten?

Eyelashes can thin, shorten, or fall out for any number of reasons, from simple habits to normal aging to medical conditions. Here are a few:

Aging and menopause often result in hormonal imbalances that thin hair, eyebrows, and eyelashes.

Rough treatment such as vigorous scrubbing while removing your makeup can result in the loss of eyelashes.

Allergic reaction to mascara is sometimes the cause of eyelash loss as well. And because mascara hardens your lashes while you wear it, sleeping in your mascara also increases the risk of eyelash breakage and shortening.

Eyelash extensions use a medical grade glue to attach to your natural lashes, and tugging them off rather allowing them to fall out on their own can result in thinning eyelashes. Pulling off false eyelashes without using an oil-based cleanser first to soften the glue also damages your natural lashes.

Medical conditions such as blepharitis (mites or bacteria in the lash line), an overactive or underactive thyroid, psoriasis, or eczema can also cause eyelashes to fall out.

Excessive stress sometimes results in hair and eyelash loss. Trichotillomania is an anxiety disorder that causes people to compulsively pull out their eyelashes.

Chemotherapy drugs often cause hair loss all over the body, including the eyelashes.


6 Reasons Why Your Eyelashes Are Falling Out, According to an Opthamologist

Making a wish on a fallen eyelash sounds sweet &mdash unless what you're wishing for is more eyelashes. For such a small part of the body, lashes can make a pretty big impact on how many of us perceive our faces. Even outside of cosmetic reasons for wanting a fuller fringe, identifying the reason behind accelerated lash loss can reveal vital information about our health. Eyelashes are more than part of the windows to the soul they sometimes point to serious underlying problems like autoimmune, thyroid, inflammatory, or even oncological conditions.

It's important to seek medical care whenever you notice a sudden change in your health, but here's where your doctor may look to first for explaining lash loss, plus tips on how to regrow your eyelashes quicker and fuller.

Your makeup routine likely isn't hurting your fringe &ndash it's forgetting to take it off at night that can cause a loss in fullness. After using wipes or other removers, following up with a mild cleanser (like baby shampoo or Cetaphil) can also help combat lash loss. "A lot of patients have the misconception that if you scrub your eyelashes with a mild soap that it'll make your lashes fall out, but that's actually incorrect," says Michelle Andreoli, MD, a clinical spokeswoman for the American Academy of Ophthalmology. "If you massage your eyelashes every night with a mild soap to get the surfaces as clean as you can and maintain the health of the eyelash follicle, your eyelashes will actually grow thicker and longer and they won't fall out as fast."

The one cosmetic you should watch out for: hot eyelash curlers. Whether you own the kind that heats ups or warm yours with a blow dryer, never put anything hot near your eye as it can damage lashes, not to mention cause potential burns.

If your lashes feel capital-I ITCHY and both lids look red and swollen, there's a solid chance you've got a case of blepharitis. It's the single most common reason for lash loss in Dr. Andreoli's clinic and it predominantly affects people of Western European descent with fair-skinned, pink-toned complexions. With blepharitis, clogged oil glands near the base of the eyelashes can lead to chronic inflammation and follicle dysfunction, therefore stopping lash growth. While practicing good eyelid hygiene will help it clear up, it's worth booking an appointment with your MD for a suspected case. An opthamologist will probably prescribe you some drops or ointments to speed the process along &mdash which will also help rule out other, more serious causes for missing lashes.

The thyroid &mdash a gland in the neck &mdash controls the body's hormones, but sometimes those levels can get out of whack. Both hyperthyroidism (an overload of hormones) and hypothyroidism (too little) list lash loss as a potential symptom, along with changes in weight, heart rate, and blood pressure. You might also feel more jittery or anxious than usual. Make an appointment with your healthcare provider, who can run some tests to rule out underlying conditions.

Have just a few eyelashes or none at all? It could stem from alopecia or another autoimmune condition. While alopecia can present in many ways, the condition inhibits hair growth on your body, head, or face. Doctors believe that this disease causes the body to attack its own hair follicles, causing full, partial, or episodic hair loss. Although no cure for alopecia currently exists, a doctor can prescribe treatments that may help hair regrow more quickly.

Similar to alopecia, chronic inflammatory diseases describe conditions where the body attacks itself. For example, both rheumatoid arthritis and lupus can affect the healthy cells and tissues in the joints, organs, and blood vessels. Since these internal diseases don't always have many external signs, it's important to pay attention to small but noticeable changes &mdash like hair and lash loss &mdash that can signal something larger at play.

If you're missing lashes on a specific part of your eyelid but have normal fringe elsewhere, see a doctor straight away. Cancers on the eyelid can interrupt eyelash growth as these harmful cells spread. Since these are difficult to remove, the sooner you can take action the better. Catching it earlier will also minimize the aesthetic impact of surgery.

For this reason, Dr. Andreoli advises practicing agressive sun protection all the time &mdash no matter the weather. "Even if it's cloudy, you should have sunglasses on," she says. "I nag my patients and I nag my young kids, if it's daytime and you're outside, your sunglasses go on. It not only protects the eyes, but it protects the skin of the lid."

Lashes take about 90 days to grow from stem to stern, Dr. Andreoli says, but it is possible to encourage that process along and prevent further lash loss.

Eyelid Hygiene: Remove your eye makeup every night with wipes, liquid, or cream. Then massage the lids with a mild cleanser like Cetaphil or baby shampoo before rinsing with hot water.

Hot Compresses: Warm washcloths placed over the eyes can help keep your lids clean and soothe any inflammation.

Latisse: The prescription treatment works better than most people realize, Dr. Andreoli says, and it's quite safe when applied correctly. (She's even used it herself!) Patients can see noticeable improvement within eight to 12 weeks, and it can also help chemotherapy patients dealing with lash loss.

Skip copycat products outside of the doctor's office though because it&rsquos difficult to determine what active ingredients they contain and predict their effect, advises Danusia Wnek, a chemist in the Good Housekeeping Institute Beauty Lab.

For a temporary alternative, boost lashes with mascara, which uses waxes and pigments to coat hairs, making them appear longer, fuller, and darker. Try the Beauty Lab&rsquos top-tested mascara for lengthening, IT Cosmetics Superhero Mascara. Just don't forget to take it off!

For more resources about lash loss, you can visit the American Academy of Ophthalmology EyeSmart website for more tips and help finding an opthamologist near you.


The coronavirus isn’t alive. That’s why it’s so hard to kill.

Please Note

The Washington Post is providing this important information about the coronavirus for free. For more free coverage of the coronavirus pandemic, sign up for our Coronavirus Updates newsletter where all stories are free to read.

Viruses have spent billions of years perfecting the art of surviving without living — a frighteningly effective strategy that makes them a potent threat in today’s world.

That’s especially true of the deadly new coronavirus that has brought global society to a screeching halt. It’s little more than a packet of genetic material surrounded by a spiky protein shell one-thousandth the width of an eyelash, and it leads such a zombielike existence that it’s barely considered a living organism.

But as soon as it gets into a human airway, the virus hijacks our cells to create millions more versions of itself.

There is a certain evil genius to how this coronavirus pathogen works: It finds easy purchase in humans without them knowing. Before its first host even develops symptoms, it is already spreading its replicas everywhere, moving onto its next victim. It is powerfully deadly in some but mild enough in others to escape containment. And for now, we have no way of stopping it.

As researchers race to develop drugs and vaccines for the disease that has already sickened 350,000 and killed more than 15,000 people, and counting, this is a scientific portrait of what they are up against.

‘Between chemistry and biology’

Respiratory viruses tend to infect and replicate in two places: In the nose and throat, where they are highly contagious, or lower in the lungs, where they spread less easily but are much more deadly.

This new coronavirus, SARS-CoV-2, adeptly cuts the difference. It dwells in the upper respiratory tract, where it is easily sneezed or coughed onto its next victim. But in some patients, it can lodge itself deep within the lungs, where the disease can kill. That combination gives it the contagiousness of some colds, along with some of the lethality of its close molecular cousin SARS, which caused a 2002-2003 outbreak in Asia.

Another insidious characteristic of this virus: By giving up that bit of lethality, its symptoms emerge less readily than those of SARS, which means people often pass it to others before they even know they have it.


Amaurosis fugax

The experience of amaurosis fugax is classically described as a temporary loss of vision in one or both eyes that appears as a "black curtain coming down vertically into the field of vision in one eye" however, this altitudinal visual loss is relatively uncommon. In one study, only 23.8 percent of patients with transient monocular vision loss experienced the classic "curtain" or "shade" descending over their vision. [4] Other descriptions of this experience include a monocular blindness, dimming, fogging, or blurring. [5] Total or sectorial vision loss typically lasts only a few seconds, but may last minutes or even hours. Duration depends on the cause of the vision loss. Obscured vision due to papilledema may last only seconds, while a severely atherosclerotic carotid artery may be associated with a duration of one to ten minutes. [6] Certainly, additional symptoms may be present with the amaurosis fugax, and those findings will depend on the cause of the transient monocular vision loss. [ citation needed ]

Prior to 1990, amaurosis fugax could, "clinically, be divided into four identifiable symptom complexes, each with its underlying pathoetiology: embolic, hypoperfusion, angiospasm, and unknown". [7] In 1990, the causes of amaurosis fugax were better refined by the Amaurosis Fugax Study Group, which has defined five distinct classes of transient monocular blindness based on their supposed cause: embolic, hemodynamic, ocular, neurologic, and idiopathic (or "no cause identified"). [8] Concerning the pathology underlying these causes (except idiopathic), "some of the more frequent causes include atheromatous disease of the internal carotid or ophthalmic artery, vasospasm, optic neuropathies, giant cell arteritis, angle-closure glaucoma, increased intracranial pressure, orbital compressive disease, a steal phenomenon, and blood hyperviscosity or hypercoagulability." [9]

Embolic and hemodynamic origin Edit

With respect to embolic and hemodynamic causes, this transient monocular visual loss ultimately occurs due to a temporary reduction in retinal artery, ophthalmic artery, or ciliary artery blood flow, leading to a decrease in retinal circulation which, in turn, causes retinal hypoxia. [10] While, most commonly, emboli causing amaurosis fugax are described as coming from an atherosclerotic carotid artery, any emboli arising from vasculature preceding the retinal artery, ophthalmic artery, or ciliary arteries may cause this transient monocular blindness.

  • Atherosclerotic carotid artery: Amaurosis fugax may present as a type of transient ischemic attack (TIA), during which an embolus unilaterally obstructs the lumen of the retinal artery or ophthalmic artery, causing a decrease in blood flow to the ipsilateral retina. The most common source of these athero-emboli is an atherosclerotic carotid artery. [11]
    However, a severely atherosclerotic carotid artery may also cause amaurosis fugax due to its stenosis of blood flow, leading to ischemia when the retina is exposed to bright light. [12] "Unilateral visual loss in bright light may indicate ipsilateral carotid artery occlusive disease and may reflect the inability of borderline circulation to sustain the increased retinal metabolic activity associated with exposure to bright light." [13]
  • Atherosclerotic ophthalmic artery: Will present similarly to an atherosclerotic internal carotid artery.
  • Cardiac emboli: Thrombotic emboli arising from the heart may also cause luminal obstruction of the retinal, ophthalmic, and/or ciliary arteries, causing decreased blood flow to the ipsilateral retina examples being those arising due to (1) atrial fibrillation, (2) valvular abnormalities including post-rheumatic valvular disease, mitral valve prolapse, and a bicuspid aortic valve, and (3) atrial myxomas.
  • Temporary vasospasm leading to decreased blood flow can be a cause of amaurosis fugax. [14][15] Generally, these episodes are brief, lasting no longer than five minutes, [16] and have been associated with exercise. [10][17] These vasospastic episodes are not restricted to young and healthy individuals. "Observations suggest that a systemic hemodynamic challenge provoke[s] the release of vasospastic substance in the retinal vasculature of one eye." [16] : Giant cell arteritis can result in granulomatous inflammation within the central retinal artery and posterior ciliary arteries of eye, resulting in partial or complete occlusion, leading to decreased blood flow manifesting as amaurosis fugax. Commonly, amaurosis fugax caused by giant cell arteritis may be associated with jaw claudication and headache. However, it is also not uncommon for these patients to have no other symptoms. [18] One comprehensive review found a two to nineteen percent incidence of amaurosis fugax among these patients. [19][20][21][22]vasculitis[23][24]
      [25]
    • [27][28]
        [29][30][31]

      Ocular origin Edit

        [33][24][24][29][24][34]
      • Transient elevation of intraocular pressure [8][33]
      • Intraocular hemorrhage[8][29][29]
      • Orbital hemangioma[35]
      • Orbital osteoma[36][29] testing

      Neurologic origin Edit

      Neurological causes include:

        [8]
      • Compressive optic neuropathies[8][29] : "The underlying mechanism for visual obscurations in all of these patients appear to be transient ischemia of the optic nerve head consequent to increased tissue pressure. Axonal swelling, intraneural masses, and increased influx of interstitial fluid may all contribute to increases in tissue pressure in the optic nerve head. The consequent reduction in perfusion pressure renders the small, low-pressure vessels that supply the optic nerve head vulnerable to compromise. Brief fluctuations in intracranial or systemic blood pressure may then result in transient loss of function in the eyes." [37] Generally, this transient visual loss is also associated with a headache and optic disk swelling. can cause amaurosis fugax due to a unilateral conduction block, which is a result of demyelination and inflammation of the optic nerve, and ". possibly by defects in synaptic transmission and putative circulating blocking factors." [38][39][40][41][42][43][44][45][46] (auras often involve temporary scotomas, and a spectrum up to transient full vision loss exists) [47][47][24]

      Despite the temporary nature of the vision loss, those experiencing amaurosis fugax are usually advised to consult a physician immediately as it is a symptom that may herald serious vascular events, including stroke. [1] [2] Restated, “because of the brief interval between the transient event and a stroke or blindness from temporal arteritis, the workup for transient monocular blindness should be undertaken without delay.” If the patient has no history of giant cell arteritis, the probability of vision preservation is high however, the chance of a stroke reaches that for a hemispheric TIA. Therefore, investigation of cardiac disease is justified. [8]

      A diagnostic evaluation should begin with the patient's history, followed by a physical exam, with particular importance being paid to the ophthalmic examination with regards to signs of ocular ischemia. When investigating amaurosis fugax, an ophthalmologic consult is absolutely warranted if available. Several concomitant laboratory tests should also be ordered to investigate some of the more common, systemic causes listed above, including a complete blood count, erythrocyte sedimentation rate, lipid panel, and blood glucose level. If a particular cause is suspected based on the history and physical, additional relevant labs should be ordered. [8]

      If laboratory tests are abnormal, a systemic disease process is likely, and, if the ophthalmologic examination is abnormal, ocular disease is likely. However, in the event that both of these routes of investigation yield normal findings or an inadequate explanation, noninvasive duplex ultrasound studies are recommended to identify carotid artery disease. Most episodes of amaurosis fugax are the result of stenosis of the ipsilateral carotid artery. [48] With that being the case, researchers investigated how best to evaluate these episodes of vision loss, and concluded that for patients ranging from 36–74 years old, ". carotid artery duplex scanning should be performed. as this investigation is more likely to provide useful information than an extensive cardiac screening (ECG, Holter 24-hour monitoring, and precordial echocardiography)." [48] Additionally, concomitant head CT or MRI imaging is also recommended to investigate the presence of a “clinically silent cerebral embolism.” [8]

      If the results of the ultrasound and intracranial imaging are normal, “renewed diagnostic efforts may be made,” during which fluorescein angiography is an appropriate consideration. However, carotid angiography is not advisable in the presence of a normal ultrasound and CT. [49]

      If the diagnostic workup reveals a systemic disease process, directed therapies to treat that underlying cause should be initiated. If the amaurosis fugax is caused by an atherosclerotic lesion, aspirin is indicated, and a carotid endarterectomy considered based on the location and grade of the stenosis. Generally, if the carotid artery is still patent, the greater the stenosis, the greater the indication for endarterectomy. "Amaurosis fugax appears to be a particularly favorable indication for carotid endarterectomy. Left untreated, this event carries a high risk of stroke after carotid endarterectomy, which has a low operative risk, there is a very low postoperative stroke rate." [50] However, the rate of subsequent stroke after amaurosis is significantly less than after a hemispheric TIA, therefore there remains debate as to the precise indications for which a carotid endarterectomy should be performed. If the full diagnostic workup is completely normal, patient observation is recommended. [8]


      What are Cholesterol Bumps on your Eyelid

      Xanthelasma and corneal arcus are two indications of elevated blood cholesterol that can be evident on the eyelids. While it is not present in every other case of hypercholesterolemia or hyperlipidemia (elevated lipids- triglycerides + cholesterol), then the presence of xanthelasma or even a corneal arcus should warrant further investigation for the alterations of blood lipids.
      There are other several disorders of the blood lipids that might lead to xanthelasma or even the corneal arcus. Similarly, these indications might be seen in a person without any disorder of blood lipids.
      Overall these eye and also eyelid signs are not very common in hypercholesterolemia and hyperlipidemia. Also, it does not lead to any discomfort or affect the functioning of an eye and also eyelids. It is often an aesthetic issue among patients.
      Elevated levels of cholesterol might not lead to any overt signs or even symptoms for a long period of time. But, hypercholesterolemia might lead to secondary to other disorders. In this case, xanthelasmas in a patient having the following conditions should raise concern of secondary hypercholesterolemia:

      • Hypothyroidism
      • Pregnancy
      • Cholestatic liver disease
      • Hyperparathyroidism
      • Nephrotic syndrome
      • Prescription drugs such as corticosteroids and diuretics
      • Type 2 diabetes
      • Central obesity

      Both xanthelasma and also the corneal arcus are non-specific signs, more especially in elderly, but should raise concerns on hypercholesterolemia in the younger age groups, especially the children. It is not a means to diagnose the hypercholesterolemia and also the relevant cholesterol blood tests requires to be conducted.
      Cholesterol on Eyelids, Around or Under the Eye
      Xanthelasma
      Xanthelasma palpebrarum is a yellow plaque of cholesterol which is evident on eyelids or periorbital area. It tends to happen in medial aspects of eye – that is the area which is closer to inner canthus or even towards the nose.
      It is also common on the upper eyelid although it can happen on both sides and on both upper and also the lower eyelids simultaneously. These particular plaques, normally described as lumps, are soft or even semi-solid. It might become harder in prolonged cases.
      Xanthomas, which are the cholesterol deposits in skin at the pressure spots such as the knees, elbows, heels and also the buttocks, are also normally present together with xanthelasma palpebrarum.
      Cholesterol Deposits Removal
      Attempts to get rid of a deposit within the home environment should not be considered. Scarring and also infection are some of consequences of removal at the hands of an untrained person. There are several medical procedures for the getting rid of xanthelasma including:

      • surgical excision
      • laser coblation
      • chemical cauterization
      • electrodessication and cryotherapy

      To see visually how some of the white spots will actually look like, here are a few images of white dots or spots. We will provide more photos while discussing each of their main causes.

      There are many causes of white spots around your lips. Some of the causes could be genetic while others are due to some illness, products used, some abnormalities or poor personal hygiene. So, what are some of the reasons why you have them, or what are these white spots?

      Fordyce Spots – yellowish white or pale small spots

      img source: medicalnewstoday.com

      If you have small yellowish, white or pale pimple or bump like spots on the sharp demarcation that is between the red colored part of your lip and your normal skin i.e. a vermilion border, they could be Fordyce spots also known as sebaceous prominence or Fordyce granules.

      According to medicalnewstoday.com, Fordyce spots are “pale red, yellow-white or skin-colored bumps or spots that appear on the shaft of the penis, the labia, scrotum, or the vermilion border of the lips of a person’s face.” They are normally about 1mm to 3mm in size and they occur when one has a sebaceous gland that lacks a hair follicle.

      Besides being on your vermilion border, they also tend to affect the buccal mucosa –“the inner lining of the cheeks and lips”.

      Fordyce spots affect male and female and they are not associated with any illness, disease, or infections. They are painless, harmless and they are not a sign of STI (sexually transmitted infection) or cancer. However, they tend to be bigger as someone grows older.

      Treatment of Fordyce spots

      Treatment is generally discouraged. However, if you really want to treat Fordyce spots, the common treatments are electro desiccation, use of pulsed dye lasers, and micro-punch technique. Chemical peels and anti-sebum ointment or creams can also be of some help.

      White spots on lips HPV STD

      img source: medicalnewstoday.com

      The other possible reason why you have white spots on your lips can be due to Human papillomavirus (HPV) infection. This infection is caused by about 200 different HPV strains, some of which have been linked to cancer of cervix, vagina, vulva, anus, and penis as well as oropharyngeal and mouth cancers.

      HPV is an STD that is “transmitted through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus”.

      Once you have it, HPV commonly affects the genital areas (vagina, vulva, cervix, penis and anus) as well as throat and mouth (in case of oral HPV), and can result to genital and oral warts respectively.

      Oral HPV can cause warts “anywhere within the oral cavity or on the lips”, which can “be white and dome shaped or flat topped growths the same color was your mouth”. For the case of lips, they are more common on the inner part of lips where they can vary from being small to spiked or cauliflower like masses that have projections.

      It is therefore a fact that HPV can cause white spots on lips. They are generally painless unless you irritate them and you can have just one or multiple of these bumps.

      Oral HPV treatment

      img source: globalresearch.ca

      HPV is not curable although some cases may disappear without treatment. Going for a HPV vaccines have been shown to help reduce risks of cervical and genital cancers. It is unknown if these vaccines can help in reducing risks of oral cancer too due to HPV oral infections.

      Note: In case of an ulcer or sore on your lips that doesn’t go away or heal after two weeks, causes pain when swallowing or a persistent lump on your neck, see you doctor.

      Milia – small hard white bumps

      If you have tiny, little or small whiteheads that keep on coming and going away, you could be having milia, which are “small, hard, white bumps” common on the face but “can occur even on mucous membranes such as the inner surface of the cheek or the vermillion border of the lips”.

      They form when skin cells are trapped instead of being naturally shed off and they are common in babies but occur even in preteens, teens and adults.

      Some ingredient in lip care products, sun damage and allergic reaction to fluoride in toothpaste are other factors that have been blamed for milia.

      Treatment of milia

      Best treatment of milia is exfoliation. However, retinol can be of help and if milia won’t come out, consider seeing a doctor or dermatologists for removal. Do not remove them forcefully.

      Oral thrush

      img source: pharmafactz.com

      Oral thrush, caused by a fungal infection can cause creamy “white lesions on the lips, mouth, gums, or tonsils”. When they are on your inner and outer lips, the lesions can appear patchy.

      Although many other strains can cause oral thrush, candida albicans is the common strain of yeast associated with oral thrush especially in people who use corticosteroids, birth control pills or antibiotics.

      Furthermore, illness such as dry mouth, cancer, HIV/AIDS infection having an organ transplant, anemia, wearing dentures, diabetes or even being pregnant can increase the risk of having oral thrush.

      Oral thrush can be managed or treated by antifungal medications (liquids, tablets or lozenges).

      Herpes simplex virus (HSV) – cold sores or fever blisters

      img source: medicalnewstoday.com

      If you have painful, itchy, white bumpy blisters on your lips, it could be cold sores or fever blisters i.e. “cold sores are small blisters that develop on the lips or around the mouth”. They are caused by a contagious viral infection transmitted by skin contact that can be treated by oral and topical antiviral medication.

      The fluid-filled blisters initially look like small sores that often come in clusters forming patches they tingle, and are common on your lip line where the lip meets normal skin and the corner of your mouth. Later on, they tend to merge before bursting living oozy shallow open sores, which will eventually crust over.

      White spots on lips cancer

      img source: medicalnewstoday.com

      If you have a white spot on your lip that initially is flat and painless and then begins being to ulcerate, it could be a due to oral cancer. This bump tends grow, be hard or never heals.

      On possible cause of oral cancer, apart from family cancer history, people who excessively drink, smoke, have HPV infections or are excessively exposed to the sun have a higher oral cancer risk factor.

      Treatment is by removal of the cancerous growth, followed by chemotherapy and/or radiation therapy. If treated diagnosed early, you can beat it.

      Canker sores

      Another cause of white spots on lips including on inside lip skin, on inside cheek or mouth in general is canker sores. Canker sores are painful, burning or tingling ulcerative patches can be round white, gray, or yellowish in color with their edges being red. They are not cancerous and fade away within two weeks.

      Canker sores can be due to allergic reactions to some food, tissue trauma, impaired immunity system and nutritional deficiencies especially iron, folic acid, zinc, or vitamin B-12. Gastrointestinal diseases such as Cohn’s disease as well as celiac disease have also blamed for canker sores.

      Treatment

      In most cases, canker sores heal without treatment. If they are severe, a doctor might prescribe corticosteroid ointment, antimicrobial mouth rinse or OTC and/or prescribed solutions to reduce irritation and pain.

      Vitiligo

      img source: homeoenergy.com

      This is a problem where your skin, including the one on your lips loses pigmentation. The exact cause is unknown but it has been associated with cancer and an autoimmune disease. Vitiligo forms more of white patches other than white spots.

      Treatment is by tropical steroid therapy, skin graft, tattooing, autologous melanocyte transplant, depigmentation, and psoralen photochemotherapy

      Mucous cysts

      img source: medicalnewstoday.com

      A mucous cyst or a mucocoele refers to fluid filled sacs, swellings or bumps that occur inside the mouth or on inside lips especially the inside lower lips. They form due to plugging of mucus from salary glands.

      They can also be due to lip biting, salivary gland rapture or piercings. When they deep in your skin, they tend to be whitish color, tender when touched and appear like a nodule.

      Usually, painless and temporary cysts that will go away after sometime but a few could form a permanent cyst, which might require treatment.

      In severe cases, treatment is by laser therapy, cryotherapy or use of intralesional corticosteroid injections.

      Contact allergy

      img source: medicalnewstoday.com

      Contact with some “chemicals like mica and titanium are especially known to induce inflammation and irritation of lip mucosa leading to lumpy bumpy appearance of lips along with irritation, burning and peeling of lip”.

      To treat contact allergy, use steroids and antihistamines especially if your lip is swollen and/or you have an inflammation. Furthermore, avoid coming in contact with the allergens (allergy causing irritants).

      White raised spot due to lip pimple

      Having a lip pimple can result to white dot on your lip. There are many causes of lip acne or pimple. See more on pimples on lips where you will cover all the causes and how to get rid of these pimples.

      Fibroma

      Fibroma refers to a “benign tumor of fibrous connective tissue” that forms a smooth lump in the oral cavity. It could be the color of your mouth (pink) or paler i.e. whitish in color.

      It is often caused by trauma especially if you have the lip biting, teeth grinding or the habit of rubbing your lips against poorly fitting dentures.

      To successful treat this bumps, which can grow one needs to go for surgical removal.

      Other causes white dots in lips

      Other possible causes include lip dryness, sunburned lip blisters (can be yellowish white), bacterial infection, hairy leukoplakia, which appear as white, patches on your lower inner lip, inside cheek and on the sides of your tongue.


      Contents

      Layers Edit

      The eyelid is made up of several layers from superficial to deep, these are: skin, subcutaneous tissue, orbicularis oculi, orbital septum and tarsal plates, and palpebral conjunctiva. The meibomian glands lie within the eyelid and secrete the lipid part of the tear film.

      Skin Edit

      The skin is similar to areas elsewhere, but is relatively thin [1] and has more pigment cells. In diseased persons these may wander and cause a discoloration of the lids. It contains sweat glands and hairs, the latter becoming eyelashes as the border of the eyelid is met. [2] The skin of the eyelid contains the greatest concentration of sebaceous glands found anywhere in the body. [1]

      Nerve supply Edit

      In humans, the sensory nerve supply to the upper eyelids is from the infratrochlear, supratrochlear, supraorbital and the lacrimal nerves from the ophthalmic branch (V1) of the trigeminal nerve (CN V). The skin of the lower eyelid is supplied by branches of the infratrochlear at the medial angle. The rest is supplied by branches of the infraorbital nerve of the maxillary branch (V2) of the trigeminal nerve.

      Blood supply Edit

      In humans, the eyelids are supplied with blood by two arches on each upper and lower lid. The arches are formed by anastomoses of the lateral palpebral arteries and medial palpebral arteries, branching off from the lacrimal artery and ophthalmic artery, respectively.

      The human eyelid features a row of eyelashes along the eyelid margin, which serve to heighten the protection of the eye from dust and foreign debris.

      Any condition that affects the eyelid is called eyelid disorder. The most common eyelid disorders, their causes, symptoms and treatments are the following:

      • Hordeolum (stye) is an infection of the sebaceous glands of Zeis usually caused by Staphylococcus aureusbacteria, similar to the more common condition Acne vulgaris. It is characterized by an acute onset of symptoms and it appears similar to a red bump placed underneath the eyelid. The main symptoms of styes include pain, redness of the eyelid and sometimes swollen eyelids. Styes usually disappear within a week without treatment. Otherwise, antibiotics may be prescribed and home remedies such as warm water compresses may be used to promote faster healing. Styes are normally harmless and do not cause long lasting damage.
      • Chalazion (plural: chalazia) is caused by the obstruction of the oil glands and can occur in both upper and lower eyelids. Chalazia may be mistaken for styes due to the similar symptoms. This condition is however less painful and it tends to be chronic. Chalazia heal within a few months if treatment is administered and otherwise they can resorb within two years. Chalazia that do not respond to topical medication are usually treated with surgery as a last resort.
      • Blepharitis is the irritation of the lid margin, where eyelashes join the eyelid. This is a common condition that causes inflammation of the eyelids and which is quite difficult to manage because it tends to recur. [3] This condition is mainly caused by staphylococcus infection and scalp dandruff. Blepharitis symptoms include burning sensation, the feeling that there is something in the eye, excessive tearing, blurred vision, redness of the eye, light sensitivity, red and swollen eyelids, dry eye and sometimes crusting of the eyelashes on awakening. Treatment normally consists in maintaining a good hygiene of the eye and holding warm compresses on the affected eyelid to remove the crusts. Gently scrubbing the eyelid with the warm compress is recommended as it eases the healing process. In more serious cases, antibiotics may be prescribed.
      • Demodex mites are a genus of tiny mites that live as commensals in and around the hair follicles of numerous mammals including humans, cats and dogs. Human demodex mites typically live in the follicles of the eyebrows and eyelashes. While normally harmless, human demodex mites can sometimes cause irritation of the skin (demodicosis) in persons with weakened immune systems.
      • Entropion usually results from aging, but sometimes can be due to a congenital defect, a spastic eyelid muscle, or a scar on the inside of the lid that could be from surgery, injury, or disease. [4] It is an asymptomatic condition that can, rarely, lead to trichiasis, which requires surgery. It mostly affects the lower lid, and is characterized by the turning inward of the lid, toward the globe.
      • Ectropion is another aging-related eyelid condition that may lead to chronic eye irritation and scarring. It may also be the result of allergies and its main symptoms are pain, excessive tearing and hardening of the eyelid conjunctiva.
      • Laxity is also another aging-related eyelid condition that can lead to dryness and irritation. Surgery may be necessary to repair the eyelid to its natural position. In certain instances, excessive lower lid laxity creates the Fornix of Reiss – a pocket between the lower eyelid and globe – which is the ideal location to administer topical ophthalmic medications.
      • Eyelid edema is a condition in which the eyelids are swollen and tissues contain excess fluid. It may affect eye function when it increases the intraocular pressure. Eyelid edema is caused by allergy, trichiasis or infections. [5] The main symptoms are swollen red eyelids, pain, and itching. Chronic eyelid edema can lead to blepharochalasis.
      • Eyelid tumors may also occur. Basal cell carcinomas are the most frequently encountered kind of cancer affecting the eyelid, making up 85% to 95% of all malignant eyelid tumors. [6] The tumors may be benign or malignant. Usually benign tumors are localized and removed before becoming a cancerous threat and before they become large enough to impair vision. Malignant tumors on the other hand tend to spread to surrounding areas and tissues.
      • Blepharospasm (eyelid twitching) is an involuntary spasm of the eyelid muscle. The most common factors that make the muscle in the eyelid twitch are fatigue, stress, and caffeine. [7] Eyelid twitching is not considered a harmful condition and therefore there is no treatment available. Patients are however advised to get more sleep and drink less caffeine.
      • Eyelid dermatitis is the inflammation of the eyelid skin. It is mostly a result of allergies or contact dermatitis of the eyelid. Symptoms include dry and flaky skin on the eyelids and swollen eyelids. The affected eyelid may itch. Treatment consists in proper eye hygiene and avoiding the allergens that trigger the condition. In rare cases, topical creams may be used but only under a doctor's supervision.
      • Ptosis (drooping eyelid) is when the upper eyelid droops or sags due to weakness or paralysis of the levator muscle (responsible for raising the eyelid), or due to damage to nerves controlling the muscle. It can be a manifestation of the normal aging process, a congenital condition, or due to an injury or disease. Risk factors related to ptosis include diabetes, stroke, Horner syndrome, Bell's Palsy (compression/damage to Facial nerve), myasthenia gravis, brain tumor or other cancers that can affect nerve or muscle function.
      • Ablepharia (ablepharon) Congenital absence of or reduction in the size of the eyelids. [8]

      Surgery Edit

      The eyelid surgeries are called blepharoplasties and are performed either for medical reasons or to alter one's facial appearance.

      Most of the cosmetic eyelid surgeries are aimed to enhance the look of the face and to boost self-confidence by restoring a youthful eyelid appearance. They are intended to remove fat and excess skin that may be found on the eyelids after a certain age.

      Eyelid surgeries are also performed to improve peripheral vision or to treat chalazion, eyelid tumors, ptosis, extropion, trichiasis, and other eyelid-related conditions.

      Eyelid surgeries are overall safe procedures but they carry certain risks since the area on which the operation is performed is so close to the eye.

      An anatomical variation in humans occurs in the creases and folds of the upper eyelid.

      An epicanthic fold, the skin fold of the upper eyelid covering the inner corner (medial canthus) of the eye, may be present based on various factors, including ancestry, age, and certain medical conditions. In some populations the trait is almost universal, specifically in East Asians and Southeast Asians, where a majority, up to 90% in some estimations, of adults have this feature. [9]

      The upper eyelid crease is a common variation between people of Caucasian and East Asian ethnicities. [10] Westerners commonly perceive the East Asian upper eyelid as a "single eyelid". [10] However, East Asian eyelids are divided into three types – single, low, and double – based on the presence or position of the lid crease. [11] Jeong Sang-ki et al. of Chonnam University, Kwangju, Korea, in a study using both Asian and Caucasian cadavers as well as four healthy young Korean men, said that "Asian eyelids" have more fat in them than those of Caucasians. [10]

      Prevalence Edit

      Prevalence of double eyelid among Asian populations [12]
      Year Ethnic group Gender Prevalence of double eyelid
      1896 Japanese Female 82–83%
      2000 Chinese Singaporean Female 66.7%
      2007 Korean Male 24.1%
      Female 45.5%
      2008 Asian Male 30.3%
      Female 41.3%
      2009 Asian N/A 50.0%
      2013 Taiwanese Chinese Female 83.1%

      Cosmetic surgery Edit

      Blepharoplasty is a cosmetic surgical procedure performed to correct deformities and improve or modify the appearance of the eyelids. [13] With 1.43 million people undergoing the procedure in 2014, [14] blepharoplasty is the second most popular cosmetic procedure in the world (Botulinum toxin injection is first), and the most frequently performed cosmetic surgical procedure in the world. [15]

      East Asian blepharoplasty, or "double eyelid surgery", has been reported to be the most common aesthetic procedure in Taiwan and South Korea. [16] Though the procedure is also used to reinforce muscle and tendon tissues surrounding the eye, the operative goal of East Asian blepharoplasty is to remove the adipose and linear tissues underneath and surrounding the eyelids in order to crease the upper eyelid. [17] A procedure to remove the epicanthal fold (i.e. an epicanthoplasty) is often performed in conjunction with an East Asian blepharoplasty. [18]

      The use of double sided tape or eyelid glue to create the illusion of creased, or "double" eyelids has become a prominent practice in China and other Asian countries. There is a social pressure for women to have this surgery, and also to use the alternative (taping) practices. [19] Blepharoplasty has become a common surgical operation that is actively encouraged, whilst other kinds of plastic surgery are actively discouraged in Chinese culture. [20]

      Death Edit

      After death, it is common in many cultures to pull the eyelids of the deceased down to close the eyes. This is a typical part of the last offices.


      Watch the video: I have white eyelashes!?! (May 2022).


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