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Oculoplasty Orbit Aesthetic and Oncology

Oculoplasty — often referred to as ophthalmic plastic surgery and oculoplastic surgery — is surgery related to the eye and its surrounding structures. It also deals with the various diseases of the eyelids and lacrimal system, and is commonly called both an art and science of plastic surgery! Oculoplasty surgery may be performed to improve the eye’s functions, comfort and appearance.

What Conditions May Require Oculoplasty?

Oculoplasty goes deeper than ophthalmology, which focuses primarily on improving or restoring vision. It deals with abnormalities, wounds, and aging-related changes that impact the orbit (the bony socket surrounding the eye), tear ducts, and eyelids. Oculoplasty offers functional and cosmetic solutions by combining medical precision with aesthetic considerations.

What Conditions May Require Oculoplasty?

Also known as oculoplastics, surgical procedures may be conducted for the eye socket, eyelids, tear ducts, and parts of the face. Conditions that may require oculoplasty surgery include:

Ptosis: Also known as blepharoptosis, it is drooping of the upper lid. It could be congenital or appear later in life. It needs surgery and can be done either by using sling or by levator resection

One of the most challenging surgeries performed

Ectropian : Out ward rotation of the lids 
Needs various surgeries for correction especially lateral tarsal strip

Entropian: inward rotation of the lids .It can be upper or lower lid 
Lower lid will need lateral tarsal strip or Weiss procedure and congenital needs Hotz procedure

Entropian: inward rotation of the lids .It can be upper or lower lid Lower lid will need lateral tarsal strip or Weiss procedure and congenital needs Hotz procedure
Upper lid will need mucous membrane graft

ADULT NLD BLOCK:

NEEDS EXTERNAL DCR or ENDONASAL DCR

ENDONASAL DCR IS A SCARLESS SURGERY AND JUSTA HANDFUL OCULOPLASTY SURGEONS CAN PERFORM IN INDIA

BLEPHAROPHIMOSIS SYNDROME: BPES is a clinical syndrome that involves blepharophimosis, ptosis, epicanthus inversus, and telecanthus. Horizontal shortening of palpebral fissure: Normal horizontal palpebral fissures measure 25-30mm; in BPES, the palpebral fissures measure 20-22mm

Saai Eye Hospital's Oculoplastic Procedure Types

Eyelid Surgery: Our surgeons skillfully manage a variety of eyelid treatments guaranteeing little scarring and optimal functional and aesthetic outcomes, whether the treatment is for droopy eyelids (ptosis) that impair vision or the excision of ugly growths.

Tear Duct Surgery: Recurrent eye infections and continuous weeping can be brought on by blocked tear ducts. Our cutting-edge techniques guarantee that tear drainage is restored, reducing pain and any consequences.

Orbital Surgery: Diseases such as thyroid eye disease or tumors may require bone socket operations. Both the esthetic result and the health of the eye are given top priority at Shekar Eye Hospital.

Management

Management of BPES should address the eyelid malformations, any related visual impairment, and primary ovarian insufficiency. Prompt surgical correction of the eyelid malformations can help prevent visual impairment from amblyopia, but later surgeries allow for more precise ptosis correction. For this reason, the exact timing of eyelid surgery is controversial. Once amblyopia has been ruled out, management of the eyelid malformations typically involves correcting the epicanthus inversus and telecanthus at three to five years of age, followed by ptosis correction one year later. A medial canthoplasty is typically done to target the epicanthus inversus and telecanthus, and a lateral canthoplasty can widen the horizontal palpebral fissure and help correct the blepharophimosis. 

Below are general recommendations for surgical intervention in BPES:

Orbital Surgery: Diseases such as thyroid eye disease or tumors may require bone socket operations. Both the esthetic result and the health of the eye are given top priority at Shekar Eye Hospital.

surgical correction can be delayed until the patient is 3 to 5 years of age, if the visual axis remains unobstructed.

A single-stage or two-stage correction may be offered if the visual axis is deemed obstructed but the vertical interpalpebral fissure height measures more than 2 mm.

a two-stage correction, beginning with ptosis correction first to avoid the development of vision-deprivation amblyopia, later followed by a medial canthoplasty, may be considered early if the central visual axis is deemed obstructed and the vertical interpalpebral fissure height measures less than 2 mm.

Orbital fractures: Problems in the orbit of the eye or the eye socket may arise when there is a break in one of the bones surrounding the eyeball. This may happen due to an injury when something hits the eye very hard. A fracture may cause double vision and a sunken small appearance of the eye.

Eyelid retraction: Eyelid retraction is the displacement of the upper eyelid superiorly or the lower eyelid inferiorly. It occurs from an increase in retractor force, as well as from scarring or other mechanical forces.

Blepharochalasis: Blepharochalasis or blepharochalasis syndrome is a condition of episodic inflammation of the eyelids, especially seen in younger people. Excess fat may gather above and below the eyelids, causing sagging eyebrows and droopy upper lids. The lower eyelids are usually not affected.

Ocular Tumours: The surgery may be required when there is a tumour in the eye (ocular tumour). Tumours are collections of cells that grow and multiply abnormally and form masses.

Eyelids turning in or out (Entropion/Ectropion): When the eyelid is turned inward (inverted) causing the eyelashes to rub against the eyeball, the condition is called entropion. When the eyelid is turned outward (everted) so that its edge does not touch the eyeball, it is referred to as ectropion.

Socket Reconstruction: This is not a condition per se, but the surgery is done before performing customised ocular prosthesis on a patient. Ocular prosthesis is the process of giving someone a prosthetic eye, or an artificial replacement for an eyeball. A prosthetic eye is a common option for someone who has lost an eye. The surgery involves natural eye removal and ocular implantation.

AESTHETIC SURGERY:

Blepharoplasty (BLEF-uh-roe-plas-tee) is a type of surgery that removes excess skin from the eyelids. With age, eyelids stretch, and the muscles supporting them weaken. As a result, excess skin and fat can gather above and below your eyelids. This can cause sagging eyebrows, droopy upper lids and bags under the eyes. Besides aging, severely sagging skin around the eyes can reduce side vision (peripheral vision), especially the upper and outer parts of the visual field. Blepharoplasty can reduce or get rid of these vision problems. The surgery can also make eyes look younger and more alert.

AESTHETIC SURGERY:

The term “lower blepharoplasty” includes a collection of surgical techniques that aims to improve the appearance of the lower eyelids. Historically, lower blepharoplasty was a reductive procedure in which skin and/or fat was removed in order to reduce lower eyelid wrinkles, skin redundancy, and fat bulges. While fat and skin excision is still performed with modern lower blepharoplasty , present trends follow a tissue-preserving philosophy that may include orbital and sub-orbicularis fat repositioning and fat transfer techniques to restore apparent volume loss associated with facial aging. In the early 2000’s, hyaluronic acid-based dermal fillers emerged as an off-label means of lower eyelid and infra-orbital volumization. Laser energy and light-based treatments have also been applied to the lower eyelids, providing non-surgical lower blepharoplasty options or non-surgical adjuncts to incisional blepharoplasty.

LOWER LID BLEPHAROPLASTY:

The term “lower blepharoplasty” includes a collection of surgical techniques that aims to improve the appearance of the lower eyelids. Historically, lower blepharoplasty was a reductive procedure in which skin and/or fat was removed in order to reduce lower eyelid wrinkles, skin redundancy, and fat bulges. While fat and skin excision is still performed with modern lower blepharoplasty , present trends follow a tissue-preserving philosophy that may include orbital and sub-orbicularis fat repositioning and fat transfer techniques to restore apparent volume loss associated with facial aging. In the early 2000’s, hyaluronic acid-based dermal fillers emerged as an off-label means of lower eyelid and infra-orbital volumization. Laser energy and light-based treatments have also been applied to the lower eyelids, providing non-surgical lower blepharoplasty options or non-surgical adjuncts to incisional blepharoplasty.

Facial lifts Non invasive thread lifts

A thread lift is a nonsurgical cosmetic procedure that lifts and tightens your skin for a younger look. A thread lift also stimulates your body’s collagen production. Collagen creates firmer, more supple skin and naturally diminishes with age. A thread lift procedure has a quick recovery with minimal complications.

Oculoplasty orbit Aesthetic and onco surgery

Various lid cancers chilhood cancer like retinoblastoma ,conjunctival cancer like OSSN , orbital cancer both beningn and malignant cancers like haemongiomas and lymphomas

What is thyroid eye disease (TED)?

TED is an autoimmune disease in which the eye muscles and fatty tissue behind the eye become inflamed. This inflammation can push the eyes forward (“staring” or “bulging”) or cause the eyes and eyelids to become red and swollen. In some individuals, the inflammation may involve the eye muscles, causing the eyes to become out of line, leading to double vision. In rare cases, TED can cause blindness from pressure on the nerve in the back of the eye or ulcers that form on the front of the eye (cornea). TED is an autoimmune disease, meaning that the inflammation and scarring are caused by an attack from the body’s immune system.

What are the symptoms of thyroid eye disease?

Bags under the eyes
Blurred/double vision
Change of the eyes’ appearance (usually staring/bulging)
Difficulty moving the eyes
Dry or watery eyes Gritty feeling in the eyes
Low tolerance of bright lights
Pain in or behind the eye — especially when looking up, down, or sideways
Redness of the lids and eyes
Swelling or fullness in one or both upper eyelids

Decompression surgery, which removes bone and soft tissue from behind the eye to create more space.

Eye muscle surgery, which corrects severe double vision.

Eyelid surgery, which improves the appearance and function of the eyelids.

Other recommendations for TED patients can include:

Prism glasses for double vision

High-dose steroid medications and/or radiation to improve inflammation and double vision Support groups/counseling to address the social and psychological effects of the appearance of the eyes

Patients can control the severity of TED symptoms by:

Quitting smoking. TED treatments are less effective for current smokers.

Taking selenium supplements, which are available over the counter.

Maintaining normal levels of thyroid hormones. Test your blood regularly and follow your doctor’s instructions, including taking prescribed medications.

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