Oculoplastic surgery

Introduction

Abnormalities of the ocular area may be due to developmental abnormalities, congenital defects, and trauma or ocular tumors. The primary aim of oculoplastic surgery is not only to repair and rectify the functional problems of the ocular area but to also restore the aesthetics of the face.

The plastic surgery of the orbital area is known as oculoplastic surgery and this is a sub specialty of ophthalmic and plastic surgery. Mostly oculoplastic surgery is done in the cases where the eye area has suffered damage due to trauma or a tumor has been excised. The oculoplastic surgery may be done on the orbital area, the socket of the eye, the lacrimal apparatus etc.

The various oculoplastic procedures can treat disorders like: –

  • Problems and disorders of the eyelids such as blepharospasm, eyelid tumors, trauma after effects, ptosis, ectropion or entropion etc.
  • The problems of the eye orbital area such as fracture of the orbit, Grave’s disease, tumor and orbital inflammatory syndrome etc.
  • Lacrimal apparatus disorders like trauma of lacrimal system, obstruction in the nasolacrimal duct etc.

 

Treatment

As the removal of skin cancer of the eyes invariably involves surgery, the loss of the eyelid mass is dependent upon the patient as well as the size of the tumor. The scarring is kept to a minimum during the surgery by the surgeons while making sure all the cancerous cells are removed. The large tumors are removed but their reconstruction requires use of skin flaps and skin grafts. The flaps and grafts are made using the skin which is taken from the body of the patient only.

As oculoplastic surgery is a type of super specialty which is a part of ophthalmology it requires extensively trained surgeons who have high degree of skills and precision. A thorough understanding of the anatomy of the eyes as well as an understanding of the aesthetics is required.

 

Small trauma or small growth of tumor may not require large sutures and the healing of the sutures may occur on its own. Skin grafting is the procedure in which the skin tissues are borrowed from a donor site and in cases where large tumors are excised this procedure is needed.  Skin grafts can be described as thin pieces of skin which are taken from the patient’s body and placed on the site where the surgery is performed.

Entropion is treated by oculoplastic surgery and is the condition which causes the eyelashes to turn in and rub against the white portion of the eyes which causes chafing. Entropion is generally the condition which affects the lower eyelids. Long term conjunctivitis, excessive watering of the eyes, lack of lubrication of the eyes, dryness in the white portion of the eyes may be caused due to ectropion which causes the eyelids to move outwards.

Orbital reconstruction is also an oculoplastic surgery which is required in the cases where the orbital tumors are excised. The condition of the eyes can become life threatening and may cause the loss of the eyes and vision.

In addition to bones of the orbit, bones of the orbital floor may also get broken or ruptured due to blunt trauma or force to the face. The broken bones of the orbit may cause swelling, pain, bruising or droopiness of the eyes.

The three types of the cancers of the eyelids can be benign, malignant or stye’s inflammation. The most commonly occurring cancer of the eyes is basal cell skin carcinoma which can be very easily removed with surgery. The approach taken to excise the tumor depends upon the size and the extent of the tumor and if the tumor is not treated in time it may spread to orbit, the brain and the sinus cavity etc. small sized tumors may be resected and fixed by pentagonal resection method, while the larger sized tumors may be fixed by mustarde or glabellar flaps which are transposition flaps.

A common black eye can be easily treated with a cold compress. Any foreign debris that enters the eye and sports injuries may cause the soft tissues of the eyes to be injured. In case the white portion of the eye known as cornea is damaged, a surgeon should be contacted immediately. A surgery may be necessary where the orbital area is discolored excessively or is deformed.

Diagnosis

The physical condition of the eye area generally gives the tell tale signs of the injury therefore the primary diagnostic tool is physical examination.

Risk factors and complications

Post operative instructions should be followed closely by the patients and that can largely help in avoiding the post surgery complications. Like all other surgeries, oculoplastic surgery also carries some risks with it, but they can be minimized if a skilled surgeon is chosen and the procedure is carried out at a reputed medical facility. Any deformity of the eye should be immediately taken for the treatment.

 

Dr. Debraj Shome is amongst the best oculoplastic surgeons and currently practices in Mumbai, India. He co-founded The Esthetic Clinics.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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