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OCULOPLASTY

Updated: Aug 12, 2021

OCULOPLASTY


This branch of ophthalmology deals with structures surrounding the eyeball like the eye socket (orbit), Eyelids, and tear ducts.



EYELID


Entropion & Ectropion


In- Turned lid margin (Entropion) [fig. A] or Out-Turned lid margin (Ectropion) [ fig. B] are commonly seen with age where the eyelid skin becomes loose. It can also be caused by injury or infection which causes scarring and rarely due to eyelid tumours.






The treatment is by surgery done by a trained oculoplastic surgeon who ensures a perfect correction with intact functionality of eyelids.






Ptosis


Drooping of eyelids (ptosis) can be congenital (by birth) or acquired (developed later in life).




Correction requires surgery -the choice of which depends upon the degree of drooping and power of muscle which helps in lifting the eyelid.





Blepharospasm and hemifacial spasm



Involuntary blinking or spasm of the eyelids (blepharospasm) and associated twitching of one half of the face (hemifacial spasm) can be treated with Botulinum injection or surgery based on the severity.









Baggy eyelids




Lacrimal



Tears produced in the eye normally get drained via lacrimal drainage system.


A blockage in this tear drainage system results in watering.Blockage can be complete or partial and at any site from the puncta to nasolacrimal duct.

Long-standing blockage can cause infection resulting in a painful swelling and discharge.


This can occur at all ages from infants to elderly.



Treatment initially involves medication to control infection.

Repeated episodes of infection warrant- probing, intubation and as a last resort - surgery (Dacrocystorhinostomy or DCR / Dacrocystectomy or DCT).






Eye Tumors


Tumors in the eye, like elsewhere in the body can be Benign(or localised to eye) OR Malignant ( can spread to other lasers of body). Treatment of eye tumors has to be done making sure the tumour is cured and at the same time the structure and function of eye is saved as much as possible.


We at Sharan Hospital manage the following :


Ocular Surface tumors - tumors involving the white part of eyeball ( sclera) and/or transparent structure in front of the black part of eye (Cornea).


Eyelid tumors - they appear as a mass or lump and sometimes as an ulcer on the eyelid. Any suspicious mass on the eyelid which is gradually increasing in size, or bleeding should be examined and preferably removed and the biopsy sent for pathology testing to identify whether it is a tumor.


Orbital Tumors - grow behind the eye and can cause bulging or displacement of the eye , double vision, or sometimes loss of vision.

A CT or MRI scan is required to identify the presence and extent of the tumor.


Intra-ocular Tumors - are tumors that grow inside the eye and cause decrease in vision.


Orbital and intra-ocular tumors require a multi-speciality approach- requiring the combined effort of an Oculoplasty Surgeon, Pathologist, Retina Surgeon, and a Medical Oncologist.


Management


Non-invasive topical chemotherapy treatment without surgery for the initial stages of ocular surface tumours.


Special Surgery Technique ( NO TOUCH technique) with Cryotherapy (freezing therapy )- is used to remove the ocular surface tumors.


Lid reconstruction - is needed for eyelids after the removal of eyelid tumours.



Orbitotomy - for removal of orbital tumors


Enucleation and Exentration - removal of eyeball is necessary for advanced Intraocular Tumors




Ocular prosthesis



Any patient Who has been unfortunate to lose an eye because of an eye disease/tumour or trauma suffers from a pain which extends beyond the loss of vision. This suffering is due to disfigurement And social stigma - All of which leads to a psychological setback for the patient.

We at Sharan Hospital offer custom-made ocular prosthesis or artificial eye which make for superior user comfort as well as provide cosmesis as close to the natural eye possible.




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