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Oculoplastics

Oculoplastics includes a variety of surgical procedures that relate to the orbit (eye socket), eyelids, tear ducts, and the face. The following is a list of common oculoplastic related disorders:

Eyelid Disorders

  • Eyelid Surgery: Drooping of the upper lids (ptosis) or malposition of the lower lids (ectropion or entropion) can be corrected by out patient surgery under local anesthesia. 
  • Botox for Blepharospasm: Blepharospasm is a rhythmic, spasmodic, uncontrollable contraction of the eyelids and facial muscles. Initial treatment usually begins with Botox injections to quiet the spastic muscles. Botox is a modified derivative of botulinum toxin, and produces a relaxing, paralytic effect on muscles. It also is used cosmetically to eliminate wrinkles, especially wrinkles of the mid-brow and forehead, as well as crow’s feet at the corners of the eyes. Surgery is another option available for Blepharospasm. Follow these links for more information on blepharospasm and other eyelid problems.

Lacrimal Disorders

  • Tearing: Dry eyes, eyelid infections and inflammations, eyelid malpositions, and corneal diseases can cause overproduction of eye fluid, or tearing. Dry eye is a common cause of tearing and many different treatments exist, including tear replacement and closure of the punctum, the tear drainage opening. Eyelid malposition, such as inward or outward turning of the eyelid, can also cause tearing, as can eyelid laxity. Blockage of the tear drainage pathway can cause tearing. At times, the punctum is closed; at other times, the closure may be in the nasolacrimal duct, which can occur in children and adults. Sometimes conservative treatment can clear the problem while in other cases surgery may be required.

Oculoplastic Surgery with Reconstruction of Lid Disorders

  • Reconstructive Eye Surgery: Complex facial fractures are managed in consultation with the ENT and Cosmetic Surgery Departments to achieve optimal reconstruction. Reconstruction of the areas around the eyes involves both simple and complex flaps and grafts to achieve the best cosmetic and functional results. Lesions of the orbit or eyelids, especially cancers, can be quite extensive. Sometimes MOHS microsurgery is necessary for the most efficient tumor excision. Problems involving orbital decompression (such as Graves’ Disease) may require surgery to restore vision. Lid release surgery is sometimes necessary to restore the appearance of the eye after serious damage from disease or injury. Ptosis, the drooping of the eyelids that can be present at birth or develop over time can interfere with vision. Sometimes surgery to elevate the eyelid may improve a person’s peripheral vision.
  • Orbital Tumors and Fractures: Orbital tumors may be benign or malignant (i.e. cancerous) and occur in adults or children. Each patient with a suspected orbital tumor receives a comprehensive eye exam and appropriate imaging to help plan the treatment of the disorder. Thyroid dysfunction (Graves’ disease) may affect the eyes and surrounding tissues making the eyes dry and irritated. Occasionally, this causes the eyelids and underlying soft tissue to swell. Less often, more serious disorders can occur such as proptosis (bulging of the eye), decreased vision, eyelid mal-position, and diplopia (double vision). Patients with an orbital disorder should bring a copy of any pertinent radiologic studies (such as MRI or CT scan), old photographs, and records of previous laboratory tests and treatments.

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