Usually, people know what a “Plastic Surgeon” does and assume that all plastic surgeons are trained to perform the same surgeries. While both general “Plastic Surgeons” and “Oculoplastic Surgeons” are trained to perform surgery on the skin, muscles, and bones of the human body, Oculoplastic Surgeons focus their expertise on the area around the eye. By focussing their study and practice only to the area surrounding the face, Oculoplastic Surgeons become experts in both reconstructive, functional and cosmetic surgery of the human face surrounding the eyes.
If you are visiting an oculoplastic surgeon, or your doctor has recommended a visit to an oculoplastic surgeon; here are some details that may be useful. Oculoplastics in itself, is a specialized branch of ophthalmology (Eye surgery) that deals with the eyelids, the bony socket, disorders of the tear ducts as well as cosmetic surgeries and procedure performed around the eye. Oculoplastic surgery also includes the treatment of tumours or cancers of the eye.
Your oculoplastic surgeon may advise one or more surgeries that may be necessary.
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- Ptosis correction: Ptosis in a condition where one or both eyelids are droopy resulting in the eye(s) appearing smaller. Ptosis correction is a surgery to correct the eyelid drooping.
- Blepharoplastycommonly known as ‘eyelift’ is plastic surgery of the eyelids to remove excessive skin or subcutaneous fat. This can be performed for the upper eyelid and the lower eyelid.
- Entropion and Ectropion correction: Entropion is a condition where the eyelid margin is turned inwards and this results in the eyelashes rubbing against the eye surface causing watering and discharge. An entropion correction surgery corrects the eyelid position. Similarly, ectropion is a condition where the eyelid margin is turned outwards and needs to be corrected.
- Eyelid tumour excision with reconstruction
- Chalazion surgery: A chalazion is one of the most common causes of an eyelid lump or swelling. It slowly develops primarily due to blockage and swelling of an oil gland in the eyelid. An oculoplastic surgeon usually performs a surgery from the inner side of the eyelid so as to avoid a scar. It is a quick and effective procedure with minimal down-time.
Surgeries involving the tear duct / lacrimal apparatus:
Oculoplastic surgeons are experts at surgical procedures to correct a watering eye due to blockage in the tear duct. Depending on the location of the blockage, or age of the patient, an oculoplastic surgeon may advise any of the following procedures:
- Dacryocystorhinostomy(DCR): is a procedure which is performed when the tears from the eye do not flow into the nose due to an obstruction in the passage. This surgery can be done either externally on endoscopically through the nose.
- Dacryocystectomy (DCT): is a surgery where the lacrimal sac (or the duct that drains the tears) is removed surgically.
- Probing of the nasolacrimal duct: In children, If the opening of the tear ducts are blocked, the tears will not be able to drain away and will build up. A probing is a minimally invasive technique where the membranous obstruction at the lower end of the nasolacrimal duct is opened up.
Reconstructive Surgery involving the removal of the eye:
- Enucleationis the removal of the eye leaving the eye muscles and remaining orbital contents intact. An implant (sphere) may be placed in the orbit in its place to add volume. This surgery is often indicated in cases where there is a tumour within the eye.
- Eviscerationis the removal of the eye’s contents, leaving the outer coats (scleral shell) This surgery is performed in a painful blind eye, a disfigured blind eye or eyes with infection that may not respond to medical therapy (endophthalmitis).
- Exenterationis a procedure that involes the removal of the entire orbital contents: the eye, extraocular muscles, fat, and connective tissues; usually for malignant orbital cancers.
- Orbital fracture repair
- Ocular prosthetics (artificial eyes): After an enucleation or evisceration, an aritifical eye or ocular prosthesis is placed to achieve good cosmesis. This is done by the oculoplastic surgeon in conjunction with a ocularist.
- Similarly, an orbital prosthesis (artificial replacement of the eye and eyelids within the discipline of Anaplastology) may be placed in the extenterated orbit after the surgery.
- Orbital decompression
- Orbital Tumor Removal – removing tumours around the eye or behind the eye that may compromise vision
- Botox injection
- Injectable filler
Images courtesy: Dr. Akshay G. Nair