Sexually Transmitted Ectoparasitic Infections

Crab lice may infest the pubic and perianal areas and can extend to the beard, axilla, and eyelashes (phthiriasis palpebrarum). Treatment should be applied to all hairy areas of the body. The CDC recommends 1 permethrin cream (synthetic pyrethroid), 1 lindane shampoo (organochlorine), or pyrethrins with piperonyl butoxide (plant extract) (2). Brown reviewed previous trials and concluded that permethrin was more effective than lindane (67). Cure rates of 60 and 57 respectively have been reported for single treatment with 1 lindane and 1 permethrin (68). Reportedly, a second treatment 1 wk later will increase the cure rate to 86 and 72 , respectively (68). A 93 cure rate with a single treatment of 5 permethrin has been reported (68).

Management and Referral

Trichiasis - epilate (pull out) the offending lashes with forceps. place one end of a Steristrip on the skin just below the lashes pull down gently until lashes are pulled off the globe Fig. 8.9 Entropion -the lid is turned towards the eye - the lashes are in contact with the ocular surface - can occur in both the lower and upper lid Fig. 8.9 Entropion -the lid is turned towards the eye - the lashes are in contact with the ocular surface - can occur in both the lower and upper lid

The Functions of Reflexes

The functions of reflexes are numerous and varied. As previously mentioned, reflexes adjust many important biological functions rapidly and efficiently without conscious effort, while other reflexes are largely protective. For example, the eye and the ear, the most delicate and sensitive sensory systems, can be damaged or destroyed by overstimulation or by accident. The amount of light admitted to the retina is controlled by the pupillary reflex, which in humans can effect a change in pupillary diameter from approximately eight millimeters in darkness to two millimeters in bright light. A sudden flash of intense light, for example, can evoke the reflex closing of the eyelids, further protecting the delicate retina. The eyeball itself is protected from drying by the blink reflex and from mechanical injury by the eyelid closure reflex. The latter reflex is triggered when an object approaches the eye or when the lashes or cornea are touched. The ear is also protected from potentially...

Phthirus pubis Crab or Pubic Louse

The crab louse occurs with some regularity in central Europe. Infestations are more frequent in adults than in children and in men more frequently than in women. This louse species can be readily differentiated from the head or body louse small, length 1.3-1.6 mm, with trapezoid or crablike body form (Fig. 11.1d). The parasites are most often found on hair of the pubic and perianal region, more rarely on hairy areas of the abdominal region, hairs around the nipples, beard hairs, eyelashes, and eyebrows. The life cycle takes three to four weeks. Deprived of a host, crab lice die at room temperature within two days.

The Anatomy of the

Tear Film Layers

The surface of the cornea is protected by the tear film. It is a trilaminar layer consisting of an anterior lipid layer, a middle aqueous phase, and a posterior mucin layer 10 . The anterior layer of the tear film contains polar and non-polar lipids secreted primarily by the meibomian (tarsal) glands. The sebaceous glands in the lid margin are in close relation to the eyelashes and also secret lipids (fig. 3). The middle aqueous layer is secreted by the main and accessory lacrimal glands. The main lacrimal gland is located in a shallow depression within the orbital plate of the frontal bone. The accessory lacrimal glands of Krause and Wolfring are located in the conjunctival fornices. The mucin layer of the tear film coats the superficial corneal epithelial cells and conjunctival surface. Tear mucins are secreted normally by the conjunctival goblet cells.

Ocular Cicatricial Pemphigoid

Progression of subepithelial conjunctival fibrosis in OCP leads to the formation of symblepharon (fibrotic bands between palpebral and bulbar conjunctiva) and ankyloblepharon (fusion of the lower eyelid to the bulbar conjunctiva) resulting in restriction of ocular mobility. Scarring also causes trichiasis and distichiasis due to alterations in eyelash follicle orientation, and this together with severe dry eye due to scar-induced blockage of tear gland openings causes damage to the corneal epithelium. Advanced OCP is hence accompanied by blinding keratopathy, corneal neovascularization, pseudopterygium formation, and progressive thinning and perforation. Bacterial superinfection follows due to several factors including use of topical steroids, bandage contact lenses, chronic irritation due to trichiasis, meibomitis and lagophthalmos. OCP is an example of an immune-mediated disorder with the primary pathology in the conjunctiva with collateral damage to the neighboring cornea and...

Ostriches And Related Birds

Fast Running Flightless Birds

Male ostriches are black with white plumes on their tail and wings. Females are grayish-brown. The head and legs are featherless. The neck is covered with down and is red or grayish. The ostrich has huge eyes with long protective lashes and has keen eyesight for spotting danger a long way off. It can make loud hissing and roaring noises.

What is Beauty

It is easy to understand why childlike features in an adult can move someone, in the same way as freckles, full red cheeks, long eyelashes, blond curls, well-defined and full lips. Among men, as we can see in a few of the great sex symbols, the side parting (Clark Gable, Gary Cooper), an untidy mane of hair (Leonardo de Caprio) and daily shaving can only be explained as the desire for a childlike appearance. It is not necessary, however, to have all these attributes one is usually sufficient. Every individual can display childlike features at any time. As regards particular features, if someone does not have these, he or she can usually acquire them with the help of cosmetic surgery. Beauty is not merely a completely natural phenomenon instead, it has been a cultural phenomenon for a long time and this is the case particularly in the present day. People try to improve themselves and women, to whom beauty is more important than it is to men (men tend to try to obtain power), try to...


Estrogens have only minimal effects on hair growth. Androgens are the most important determinant of the type of hair distributed throughout the body. The principal circulating androgen, testosterone, is converted in the hair follicle by 5-alpha reductase to dihydrotestosterone (DHT), which stimulate the dermal papilla to produce a terminal melanized hair. The effect of androgens on hair growth is skin area-specific, due to local variations in androgen receptor and 5-alpha reductase content). While the effect of androgens on hairs (i. e., terminalization of vel-lus hairs) will be more readily apparent in skin areas with a greater numbers of hair follicles, hair follicle density does not correlate with fol-licular sensitivity to androgens. Some areas of the body, termed nonsexual skin (e. g., that of the eyelashes, eyebrows, and lateral and occipital aspects of the scalp), are relatively independent of the effect of androgens.


Conjunctival inflammation (conjunctivitis) is common and causes a red eye with the injection maximal towards the fornix (the fold between globe and lid). Other causes of a red eye are shown in the Disorders hox. Conjunctivitis is often accompanied by photophobia and excessive lacrimation. Infective causes arc associated with a sticky yellow discharge which glues the lashes together. Lymph follicles may be seen as sago-like lumps on the tarsal conjunctiva and are particularly characteristic of chlamydial conjunctivitis. Allergic inflammation is characterised by itch, a white discharge anil conjunctival oedema (dhemosis). Other causes of chemosis include alcoholism, chronic respiratory failure and superior vena cava obstruction.

Eyelid Infections

Bacterial Conjunctivitis Lashes Mattered

Hordeola are infections of the lid margin sebaceous glands and manifest in two clinical forms external (stye) and internal. These two forms are differentiated by the particular group of sebaceous glands infected. An external hordeolum (stye) is an infection of the glands of Zeis, which extend along the base of the eyelash hair follicle. It is by far the most common type of hordeolum, and Staphylococcus aureus is the predominant microbial pathogen. Fig. 1. Staphylococcal blepharitis. Notice the lid margin crusting and the dandruff-like flakes adherent to the lashes. (Reprinted with permission from ref. 19.) Fig. 1. Staphylococcal blepharitis. Notice the lid margin crusting and the dandruff-like flakes adherent to the lashes. (Reprinted with permission from ref. 19.) Patients with blepharitis usually complain of bilateral eye redness, irritation, burning, and tearing. In general these symptoms constitute no more than an annoyance, but can become incapacitating during acute...

The Eye and Vision

Layers Cornea

The eye is protected by its position within a bony socket or orbit. It is also protected by the eyelids, eyebrows, eyelashes, and tears. The lacrimal (tear) glands (Fig. 18-6) constantly bathe the eyes with a lubricating fluid that drains into the nose. There is also a protective conjunctiva, a thin membrane that lines the eyelids and covers the anterior portion of the eye.