About the Department
Ophthalmic plastic surgery or Oculoplasty is a specialized branch of ophthalmology dealing with the diagnosis and treatment of cosmetic and functional deformities as well as tumors in and around the eyes. Our team of doctors at Dr Shroff’s Charity Eye Hospital comprises of highly skilled specialists trained from best centres in the country and abroad. The department is well equipped and gets referrals from across North India for treatment of various cosmetic and reconstructive surgeries around the eye. The centre also has dedicated Ocular Oncology Service managed by a multidisciplinary team of ocular oncologist, pediatric oncologist, Oculoplasty surgeon, pediatric ophthalmologist, ocular pathologist, ocularist and trained ocular oncology nurses to treat various ocular malignancies like retinoblastoma, melanoma, conjunctival carcinoma as well as various orbital tumors.
Orbit and Oculoplasty disorders.
The various disorders which are treated at the department include:
Entropion and ectropion refers to inturning or outturning of the eyelid margin and can involve both upper and lower eyelid. This is usually caused due to laxity of the eyelid tissues or scarring of the tissues of the eyelid and can manifest as persistent redness, irritation and watery eyes. If untreated, long standing cases can damage the cornea and thus cause decreased vision.
Most cases of entropion and ectropion can be corrected by simple surgical procedures done as an outpatient procedure under local anesthesia. Stitches are usually removed at 5-7 days. Surgery is done through hidden incisions and usually donot leave behind any visible scarring. Severe cases might require additional procedures like skin or mucous membrane grafting etc. Entropion and ectropion surgery are usually covered under health insurance.
Ptosis or droopy eyelids can present by birth in children or can happen in adults due to the weakness of the muscle which opens the eyelid. If left uncorrected, ptosis in small children can cause lazy eye and decrease in vision. Most cases of ptosis can be corrected by a simple surgery.
Watering from the eyes is usually due to an obstruction in the tear duct commonly because of trauma and infections. Sometimes the tear duct obstruction can be congenital and in those children the watering usually starts within first few months of life. Tear duct obstruction can be relieved by a surgery called dacryosytorhinostomy(DCR). The surgery can be done either through a small skin incision near the inner corner of eye or from inside the nose(Endonasal). In children with congenital tear duct obstruction, a simple out patient procedure called probing done under endoscopic guiding will open the blockage in most cases. Few children however might require DCR at a later age.
Thyroid eye disease causes the eye to bulge out and look prominent and can cause difference in the size of the eye aperture. It can also cause swelling, redness, watering, double vision or decreased vision. The initial phases of the disease is treated with steroid and other medications while persistent bulging of the eyes, difference in the eye size or persistent double vision might need surgery. Decompression surgery is done to put the eyeball back into the bony socket and improve the appearance of prominent eye or reduce the compression on the optic nerve. Eyelid surgery and squint surgery are also required to correct malposition of the eyelid or any squinting of the eyes.
Trauma to the eye can cause damage to the eyeball as well as to the surrounding structures like the eyelids, the tear duct or the surrounding bones(fractures). Careful examination of the patient is done to treat any injury which can affect the vision or impair the normal functioning of the eye. Damage to the tear duct of the eye due to injury can cause blockage of the duct and persistent watering if not treated immediately and appropriately. The repair of the delicate tear duct is done using silicone stents. Any injury to the eyelids also needs to be repaired carefully to retain the normal function and appearance. Orbital bone injury( fractures) can cause the eyeball to sink inside the eye socket causing it to appear smaller in size or can cause double vision due to injury to the eye muscles. The correction of the orbital fractures is done by a trained oculoplasty surgeon or along with a team of maxillofacial surgeons when injury involve other bones of the face also. The surgery is usually done via hidden incisions and does not leave any visible scar.
Ocular Prosthesis Services ( Artificial eyes)
Artificial eyes are used to restore near normal facial appearance when the eye is lost following trauma or has to be removed to treat eye cancer. The prosthetic eyes are made of medical grade polymers, are customized to match in color and size with the other eye, giving a natural look. The movements of the eyeball and eyelids are retained to the extent required with the artificial eyes. The artificial eye fits snugly within the eyelids and needs to be taken out at few weeks interval for cleaning which can be easily done by the patient at home. It usually takes about 2 days time to make a customized artificial eye. Occasionally, if the space within the eyelids is inadequate to fit the prosthesis(following severe trauma, infection or radiation therapy for cancers etc) a surgery is required to create adequate space for the same. In children where the eyeball is severely deformed by birth, near normal facial appearance can be restored by starting the process of expanding the eye socket and fitting an artificial eye early in life.