Oculoplasty is a discipline in ophthalmology that deals with plastic and reconstructive surgery around the eyeball, including the eyelids, orbit and lacrimal system.
Most of the oculoplastic conditions need surgical correction. One important indication is cosmetic, but many times these may be vision or sometimes even life threatening. So the oculoplastic surgeons should give equal attention to all perspectives.
- Nasolacrimal duct abnormalities.
- Ptosis, Entropion, Ectropion, Trichiasis, Distichiasis
- Eye lid & orbital tumours
- Thyroid related eye diseases
- Anopthalmic and contracted socket
- Orbital infections
- Fracture of the periorbital bone
All these conditions are capable of damaging the cornea and thereby vision. Immediate attention must be given to these problems.
When you find the drooping eyelid covering half or more part of the cornea, or the child has started to develop vision deficit, you will have to take advice from an eye specialist regarding immediate surgery.
DCR or dacryocystorhinostomy is a surgery performed to create a new channel between the eye and nasal cavity, designed to drain tears.
After removal of eyeball, the lost volume should be replaced with an orbital implant. On top of which, a perfectly matched artificial eye wins a good cosmetic benefit.
BOTOX injection is used to paralyze specific eye muscles to give temporary relief in some neuromuscular conditions. The treatment has to be repeated after certain time.
Thyroid diseases can cause it, or a tumor behind the eyeball could also be responsible for it. A CT scan or an MRI is a very important test for the diagnosis.
Trichiasis - Inwardly directed eyelashes. Should try to remove permanently by applying low voltage current to the roots of the lashes (Electropilation).
Entropion - Inward turning of eyelid margins towards the eyeball.
Ectropion - Outward turning of eyelid margins.In both the conditions patient may suffer from redness, watering, discharge, foreign body sensation, etc. Entropion may cause vision damaging corneal ulcers also due to rubbing of the eyelashes.
Ptosis - Drooping of the upper eyelid, one or both. It might be present since birth, and can lead to vision deficit due to light obstruction, causing “lazy eye” (Amblyopia). It requires prompt intervention. Adult ptosis might need correction for cosmetic betterment, or removing sight obstruction.
Eyelid tumors – Like tumours of any body parts these may be benign, malignant or inflammatory (styes). Inflammations are treated medically. Tumours need surgical removal with reconstruction. Biopsy to confirm nature of tumour. Eyelids are essential for healthy functioning of the eyes. So gaps in the lids have to be reconstructed immediately.
Orbital tumours - Tumours between the eyeballs and the bony orbits. They can push the eyeball to abnormal positions. They can damage vision by pressing on the eye nerve. Surgical removal of these tumours require very special skills.
Evisceration and Enucleation - Surgeries to remove non-functioning eyeballs, which may be painful, disfigured following trauma, or having tumours inside them.
Anophthalmic socket - Socket without eyeball. May be a defect since birth, or created after surgical removal of eyeballs. Cosmetic surgery to improve the looks of the patient is often psychologically very important.
Lacrimal passage obstruction - Tear drainage passage from eye to nose is blocked. Can be present since birth. Needs intervention within 1- 2 years of age before the surrounding bones become hard. In adult cases, most common surgery (DCR) creates an artificial passage through the bone into the nose. In few extreme cases the infective sac is removed.