Oculoplasty, Orbit & Facial Aesthetic Services

Introduction- Oculoplasty, Orbit & Facial Aesthetic Services

Orbit and Oculoplasty is a distinct subspecialty of Ophthalmology which deals with anomalies of the eyelids, orbit (bones behind the eye) and lacrimal (tear drainage) system. The eyelids and structures around the eyes are critical for vision. Injuries, aging changes and tumors can cause pain, vision loss and disfigurement. Changes in the eye's appearance due to aging or the loss of an eye to disease/injury can decrease one's ability to interact in social settings and can decrease one's confidence and impair self-image.

Oculoplastic procedures frequently have both functional and aesthetic purposes. For example, Blepharoplasty, a procedure for baggy and droopy eyelids, may improve peripheral vision as well as facial beauty and rejuvenation. It aims at improving function, comfort and appearance.

Indications For Oculoplastic Surgeries

Lacrimal Disorders:

• Persistent unexplained watering – May indicate punctal stenosis or a nasolacrimal duct /canalicular obstruction and/or involutional lid laxity.

• Lacrimal System Trauma.

Eyelid Disorders:

• Warts, Xanthelasmas, Cyst over the eyelids / periorbital skin.

• Lid Anomalies
- a. Involutional lid laxity
- b. Ectropion (outturned eyelids)
- c. Entropion (inturned eyelids)
- d. Involutional/congenital Ptosis (drooping of eyelids)
- e. Lid retraction (commonly seen in Thyroid patients)
- f. Eyelash abnormalities (Trichiasis)

• Drooping of eyebrows (Brow ptosis)

• Eyelid trauma with/without canalicular involvement – treated with reconstruction and canalicular stenting.

• Eyelid Tumors – treated by resection followed by reconstruction of eyelid.

• Eyelid or facial squeezing disorders: Blepharospasm, Hemifacial spasm

Orbital disorders:

• Painful blind eye/pre phthisical /phthisical eye – treated by Enucleation/Evisceration with Orbital implants followed by fitting with custom fit prosthesis(CFP).

• Care of an Anophthalmic socket – Fornix reconstruction, correction of lax lower lid, Socket reconstruction in case of volume deficit.

• Orbital fractures – mainly blowout fractures of floor – need orbital floor reconstruction.

• Orbital SOL/Tumors - managed with appropriate Orbitotomies.

Aesthetic Services:

• Drooping/tired upper lids, Loose skin around eyes (upper lid/lower lid) with/without prolapse of fat – treated with blepharoplasty.

• Wrinkles around the eyes and upper mid face – crows feet, frown lines, horizontal lines over forehead – treated with Injection Botox.

• Periorbital hollows, shallow contours, facial creases – Facial rejuvenation with dermal fillers.

Procedures

• Ptosis Correction
• Entropion and Ectropion correction
• Eyelid Tumor removal and reconstruction
• Eyelid Trauma repair
• Blepharoplasty and Brow lift
• Botox Injections
• Dacryocystorhinostomy, External and endoscopic
• Management of congenital Dacryocystitis
• Repair of Lacrimal canalicular laceration
• Enucleation with orbital implant
• Cosmetic evisceration with orbital implant
• Socket reconstruction
• Custom made artificial eye and facial prosthesis

Botox

Botox is the brand name of a toxin produced by a bacterium known as Clostridium botulinum. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.

The most common use of these injections is to temporarily relax the facial muscles that underlie and cause wrinkles, such as:

• Frown lines between the eyebrows

• Crow's-feet, the lines that fan out from the corners of the eyes

• Forehead furrows, the horizontal lines that form when you raise your eyebrows.

Noted primarily for the ability to reduce the appearance of some facial wrinkles, Botox injections are also used to treat such problems as blepharospasm (uncontrolled blinking and squeezing of the eyelids), hemi- facial spasms and strabismus (crossed eyes).

The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.