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Ocular Oncology & Oculoplasty Services

Overview

Ophthalmic plastic surgery, or Oculoplasty, is a specialized branch of ophthalmology dealing with cosmetic and functional deformities and eye tumors. The department is well-equipped and receives referrals from North India for various eye surgeries. The Ocular Oncology Service provides comprehensive care for ocular malignancies, managed by a multidisciplinary team.

Who We Are

The Department of Oculoplasty and Ocular Oncology at Dr. Shroff’s Charity Eye Hospital was established in 2009 and has experienced remarkable growth since then. The dedicated Ocular Oncology Service is managed by a multidisciplinary team of ocular oncologist, pediatric oncologist, Oculoplasty surgeon, pediatric ophthalmologist, ocular pathologist, ocularist and trained ocular oncology nurses. We offer a wide range of services, including medical and surgical treatment for cosmetic and functional eye deformities such as ptosis, proptosis, thyroid eye disease, eyelid malposition, fractures around the eye, and prosthetic rehabilitation for blind eyes. Our ocular oncology team is adept at treating various adult and pediatric eye cancers, including retinoblastoma, melanoma, eyelid tumors, and tumors of the ocular surface.

In 2015, we set up an integrated eye cancer treatment center, the first of its kind in North India, providing cutting-edge diagnostic and advanced treatment options for eye cancer, all under one roof. Apart from our clinical and research facilities, we also offer training opportunities for short-term and long-term fellows in oculoplasty and ocular oncology.

Key Facts & Figures for year 2023 - 24

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Our Experts

Other Team Members

Diagnosis & Treatment

We have a specialized team of doctors, nurses, low vision and rehabilitation facilities as well facilities for ocular pathology services, genetic counseling and prosthetic rehabilitation

Conditions We Treat

We perform surgical correction under local anesthesia through hidden incisions ensuring no visible scarring. Stitches are usually removed at 5-7 days. We also offer additional procedures like skin or mucous membrane grafting for severe cases.

We diagnose and treat Ptosis or droopy eyelids which may present by birth in children or in adults due to the weakness of the muscles. If left uncorrected, ptosis in small children can cause lazy eye and decrease in vision. We treat most cases of ptosis by a simple surgery.

Watering from the eyes is typically caused by a tear duct obstruction, often due to trauma or infections. Congenital cases may present in infancy. Dacryocystorhinostomy (DCR) surgery can effectively relieve the obstruction, either through a small skin incision near the inner corner of the eye or from inside the nose (Endonasal). For children with congenital tear duct obstruction, a minimally invasive outpatient procedure called probing is often sufficient, guided by endoscopy. Some cases may require DCR at a later age.

Thyroid eye disease causes prominent eye bulging, differing eye aperture sizes, swelling, redness, watering, double vision, and decreased vision. We are adept at treating this with medications and surgery. Steroids and medications treat initial phases, while persistent issues may require surgery. Decompression surgery places the eyeball back into the socket, improving appearance and reducing optic nerve compression. Eyelid and squint surgeries correct eyelid malposition and squinting.

We treat Eye trauma with associated  damage to the eyeball, eyelids, tear duct, and surrounding bones by a thorough examination and address any vision-related or functional issues. Prompt treatment of tear duct injuries is done using silicone stents. Eyelid injuries require careful repair to maintain function and appearance. Orbital bone fractures can lead to sunken eyeballs or double vision, and correction is carried out by oculoplasty or maxillofacial surgeons, often using hidden incisions to avoid visible scarring.

Routinely performed procedures

  •  Syringing and probing
  • DCT /DCR Surgery
  • Incision and drainage of lacrimal abscess
  • Fistulectomy
  • Botox injection to lacrimal gland
  • Evisceration
  • Evisceration + implant
  • Enucleation + implant
  • Socket reconstruction using MMG and DFG
  • Fornix formation suture
  • Secondary implant
  • Implant exchange
  •  Lid tear repair
  • Lid tear repair with canalicular repair with minimonaka
  • Entropion correction
  • Electroepilation
  • Ectropion correction
  • Skin graft
  • Cartilage graft
  • Fat grafting
  • Sling surgery for ptosis
  • Levator Resection /advancement for ptosis
  • Blepharoptosis correction
  • Blepharoplasty
  • Brow lift
  • Lid reconstruction
  • Excision biopsy of eyelid lesions
  • Levator recession
  • Botox injection for dystonia
  • Incision biopsy
  • Orbitotomy for orbital mass
  • Sclerotherapy for orbital vascular disease
  • Orbital fracture repair with titanium/ porex sheet
  • Orbital-facial fracture repair with titanium /bone graft
  • Post trauma/burn facial deformity correction
  • EUA
  • Bone marrow and CSF
  • TTT( Trans -pupillary thermotherapy)
  • Cryotherapy
  • Intravitreal/ Intracameral chemotherapy
  • Periocular injection
  • Intra-arterial chemotherapy in colloboration with interventional radiologist
  • Plaque brachytherapy
  • Intravenous chemotherapy
  • Radiotherapy
  • Enucleation + implant
  • Exenteration
  • Customized ocular/orbital  prosthesis
Routinely Performed Procedures

Routinely Treated Tumors

1.) Retinoblastoma: Retinoblastoma is the most common intraocular malignant tumor in young children, typically under 5 years old. It presents as a white reflex (cats eye reflex) in one or both eyes, arising from the retina and either grow inside the eye (endophytic) or grow outside the eye (exophytic). Timely detection and treatment are crucial to save the eye and vision, as delayed treatment can lead to fatal spread to the brain and other parts of the body. We offer treatment options including intravenous chemotherapy, laser, cryotherapy, enucleation surgery, radiotherapy, intravitreal chemotherapy, and intra-arterial chemotherapy (IAC).

2.) Melanoma: Melanoma originates from eye pigmented cells called melanocytes, and it can arise from the iris, choroid, ciliary body, or conjunctiva. These aggressive tumors mainly affect the elderly and, if left untreated, can spread to other parts of the body, potentially leading to fatality. We have trained specialists to detect and treat this cancer.

3.) Lymphoma: We treat Lymphoma, which is a malignant tumor that can affect the eye, often originating from white blood cells of the lymphatic system. Non-Hodgkin’s lymphoma commonly involves the eyeball, developing from the retina, vitreous, or optic nerve at the back of the eye.

4.) Eyelid tumor: We treat eyelid cancers  like sebaceous gland carcinoma, squamous cell carcinoma or basal cell carcinoma Complete removal by surgery under frozen section margin control is the commonest treatment modality of choice.

5.) Orbital tumor: Orbital tumors can be benign or malignant, primary or metastatic. The most common benign tumor is cavernous hemangioma, while other types include meningiomas, schwannomas, lacrimal gland tumors, optic gliomas, and sarcomas. They typically cause progressive bulging or displacement of the eyeball, with or without a visible lump. We offer Surgical removal as the primary treatment, and treat aggressive malignant tumors with additional chemotherapy and radiotherapy.

6.) Conjunctival carcinoma: Carcinoma of the conjunctiva and cornea (OSSN) is a common eye tumor, visible as a reddish/pinkish lump. Treatment options include simple surgery or topical chemotherapy medications.

7.) Secondary tumors(metastasis): Eye metastasis refers to malignant tumor cells from other parts of the body spreading to the eye. Choroidal involvement is common due to its high vascularity. Breast cancer (in females) and lung cancer (in males) are the most common sources of eye metastasis.

The Integrated Eye Cancer Treatment Centre at Dr Shroff’s Charity Eye Hospital treats more than 400 patients with eye tumor every year and has the following facilities for treatment: 

  • Trained Ocular Oncologist
  • Pediatric Oncologist
  • Radiation Oncologist(In collaboration)
  • Trained Oculoplasty surgeons
  • Ocular Oncopathology Services in house
  • In house chemotherapy facilities
  • Plaque brachytherapy facility in house
  • Pediatric anaesthesia services and facilities for same day pediatric examination under anaesthesia (EUA)
  • Trained oncology nurses
  • Investigation modalities for diagnosis and monitoring of eye cancers like
    • Ultrasound B scan
    • Ultrasound biomicroscopy
    • Anterior segment and Retinal OCT
    • Fluorescein angiography and OCT angiography
    • Imaging modalities like CT/MRI(in collaboration) etc.
  • Trans pupillary thermotherapy(TTT) and laser therapy facilities
  • Cryotherapy facilities
  • Facilities for specialized ocular surgeries like paediatric retinal, cataract, glaucoma and corneal surgeries
  • Intravitreal and intracameral chemotherapy facilities
  • Intra-arterial chemotherapy for retinoblastoma( In Collaboration)
  • In house genetic counsellor and genetic testing for ocular tumours
  • Customized ocular prosthesis services in house for prosthetic rehabilitation after treatment of eye tumors
  • Low vision and rehabilitation services

Artificial eyes are used to restore a near-normal facial appearance when the eye is lost due to trauma or removal for eye cancer treatment. Made of medical-grade polymers, these prosthetic eyes are custom-designed to match the color and size of the other eye, providing a natural look. They retain some movement of the eyeball and eyelids. The artificial eye fits comfortably within the eyelids and can be easily removed by the patient for cleaning at home every few weeks. Customized artificial eyes can be made in about 2 days. In cases where there is inadequate space within the eyelids, a surgery may be required to create enough space for the prosthesis. In children with severe eye deformities from birth, early treatment with expanding the eye socket and fitting an artificial eye can restore a near-normal facial appearance.

  • Customized Scleral shell
  • Customized Ocular Prosthesis
  • Custom graduated conformer therapy
  • Custom pressure stem conformer therapy
  • Cop Polishing
  • Orbital prosthesis

Before and After using Customised ocular prosthesis  images 

Routinely performed procedures

Other Facilities

Ocular Oncology

Ocular Prosthesis

Patient Stories

Video Story

Education

Ophthalmic education is a key pillar of SCEH’s strategic focus. Beyond teaching, SCEH drives education research and faculty development.

SCEH trains ophthalmologists in the diagnosis and management of corneal diseases through clinical evaluation and research, use of various investigative procedures, medical treatment and surgical intervention.

Long Term Ophthalmology Fellowship

Fellowship in Oculoplasty and Ocular Oncology 

Short term Ophthalmology fellowship

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Long-term Fellows
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Research Grants

Our education, publications & research figures (2022)

  • 2 short-term fellows and 3 long term fellows trained in one year
  • 32 ophthalmologists trained via short hands on courses in 2022
  • Over 15 publications and three research grants in the year 2022
  • Following training courses in the recent past:
    • iLEAP 2022 – Training on Minor OT procedures, basic diagnostic and common oculoplasty surgeries for residents in wetlab based hands on course
    • DCR course
    • PTOSIS Course
    • SOCKET Course

RESEARCH

MAJOR PUBLICATIONS

  • Treatment outcomes of oral propranolol in the treatment of periocular infantile capillary hemangioma and factors predictive of recurrence and incomplete resolution: A multi-centric study.

    Tiple, Sweety. and Kimmatkar, Prajakta. and Das, Sima. and Muralidhara, Alankrita. and, Nehashree. and Mehta. Ayush. and Patidar, Narendra. and Jain, Elesh. Oman J Ophthalmol 2023;16:75-81.
  • Intra-arterial chemotherapy in refractory and advanced intraocular retinoblastoma.

    Kumari N, Jain N, Saboo S, Parthasarathy R, Gupta V, Mahajan A, Das S. Indian J Ophthalmol. 2023 Feb;71(2):436-443. doi: 10.4103/ijo.IJO_1388_22. PMID: 36727336
  • Commentary: Can machine be taught to detect retinoblastoma?

    Das S, Varshney A. Indian J Ophthalmol. 2023 Feb;71(2):432-433. doi:10.4103/ijo.IJO_2283_22. PMID: 36727334.
  • Association of clinical course with thyroid-stimulating immunoglobulin in Graves' ophthalmopathy in Mongolians.

    Bayarmunkh O, Ganbold C, Das S. Davaatseren U, Minjuurdorj NE, Jav S. PLoS One. 2022 Nov 17;17(11):e0277055. doi: 10.1371/journal.pone.0277055. PMID: 36395261; PMCID: PMC9671436.
  • The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries.

    Global Retinoblastoma Study Group. Lancet Glob Health. 2022 Aug;10(8):e1128-e1140. doi: 10.1016/S2214-109X(22)00250-9. PMID: 35839812; PMCID: PMC9397647.
  • Reply Re: "Does Multimodal Treatment Improve Eye and Life Salvage in Adenoid Cystic Carcinoma of the Lacrimal Gland?".

    Manjandavida FP, Honavar SG, Murthy R, Das S, Vemuganti GK, Mulay K, Reddy VAP. Ophthalmic Plast Reconstr Surg. 2022 Jul-Aug 01;38(4):407-408. doi: 10.1097/IOP.0000000000002212. Epub 2022 Jul 5. PMID: 35797666.
  • Single-Staged Surgical Correction of Eyelid Sequelae Along With Lid Margin Mucous Membrane Grafting in Stevens-Johnson Syndrome and Other Cicatricial Ocular Surface Diseases.

    Shree N, Das S, Arya D, Srivastava A, Singh A, Sangwan V. Cornea. 2023 Apr 1; 42(4):404-411. doi:10.1097/ICO.0000000000003021. Epub 2022 Apr 20. PMID: 35543574.
  • Does Multimodal Treatment Improve Eye and Life Salvage in Adenoid Cystic Carcinoma of the Lacrimal Gland?

    Manjandavida FP, Honavar SG, Murthy R, Das S, Vemuganti GK, Mulay K, Reddy VAP. Ophthalmic Plast Reconstr Surg. 2022 Jul-Aug 01;38(4):348-354. doi: 10.1097/IOP.0000000000002108. Epub 2022 Dec 6. PMID:34873122.

Projects

USAID Retinoblastoma project(2020-2022):

This project aimed at addressing the treatment barriers related to Retinoblastoma management and improving the compliance rate and also upgradation of treatment facilities. 122 Retinoblastoma patients were treated under this project with improved treatment compliance and barriers were addressed.

Koshika Retinoblastoma project (From 2023 onwards…)

This current project aims to provide diagnostic , treatment and rehabilitation support to the Retinoblastoma patients.

Why SCEH

Our track record of successful treatments and positive patient outcomes in oculoplasty and ocular oncology demonstrates our commitment to excellence in this specialized field.
Choosing our oculoplasty oncology service means opting for specialized expertise, comprehensive care, and patient-centered approach, ensuring the best possible outcomes for individuals with eye tumors and related conditions.

For more queries on oculoplasty and  eye cancer treatment  contact us at 011- 4352 4444 email: sceh@sceh.net