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Oculoplastic surgeons are ophthalmologists who specialize in plastic and reconstructive surgery of the periorbital and facial tissues including the eyelids, eyebrows, forehead, cheeks, orbit (bony cavity around the eye), and lacrimal (tear) system. Our doctors are trained to do a variety of eyelid and facial surgery for adults and children.
Oculoplastic surgeons perform plastic, reconstructive, and cosmetic procedures in the following categories
- Droopy Eyelid (Ptosis)
Droopy eyelid / Ptosis can occur as a result of birth defect, injury, muscle disorder, nerve disorder, or simply due to aging. It gives a sleepy appearance, and can even obstruct vision if severe. Ptosis may also cause excessive forehead wrinkling, abnormal head posture such as chin elevation, and eye fatigue. In children below 8 years of age, severe droop might obstruct development of vision leading to a lazy (amblyopic) eye thus reducing vision. In adults, droopy eyelid is mainly a cosmetic concern. Surgery can correct this problem by repairing the muscle that lifts the eyelid. Several surgical options are available, and the type of surgery used depends upon the severity of the droop. After evaluation, your specialist will decide which surgery best suits your need. Health insurance will cover the costs of ptosis surgery, if it was acquired later in life. Any congenital deformity (present since birth) is not covered by insurance.
- Eyelid Malpositions (Entropion / Ectropion)
Eyelid malpositions are abnormal positions of the eyelid, leading to in-turning or out-turning of the eyelid (Entropion or Ectropion). This can be a birth defect, or secondary to injury or aging. Eyelid malpositions are common, and often lead to watering, light sensitivity, and even a cosmetic blemish. Eyelid malpositions can be corrected with eyelid plastic surgery, and are covered by insurance.
- Facial Spasms
The muscles of facial expression and the eyelid are normally under our voluntary control. Facial spasm is a condition in which these muscles function abnormally and are no longer under the direct control of the brain. It can affect the entire face, or just the area around the eyes. Four distinct forms of facial spasm are known: Benign Essential Blepharospasm, Hemifacial spasm, Meige syndrome, and Myokimia. Though the actual problem within the nerve is not fully understood and cannot be cured, its effect on facial muscles can be controlled by injections of Botulinum toxin, a 10 minute out patient procedure.
- Thyroid Eye Disease
Thyroid eye disease (a condition of Graves’ disease or hyperthyroidism) causes the eyes to bulge forward and the eye aperture to widen. It can lead to double vision, swelling around the eyes, discomfort, and in severe cases loss of vision. The initial (active) phase of thyroid eye disease involves frequent swelling of tissues around the eyes, double vision, and even reduction in vision in severe cases. Active phase is treated with medications (commonly Steroids) to reduce the swelling. Fortunately, the active phase of most thyroid eye disease patients ends in 18-24 months. However, the deformities (raised eyelid, prominent eyeball, or squint) may persist, and require surgery in the second (inactive) phase.
Decompression surgery, eyelid surgery and eye muscle (squint) surgery is performed during the inactive phase. Your specialist will evaluate you to find out which phase you are in, and plan your treatment accordingly. Health insurance will cover the costs of medical treatment and reconstructive surgery for thyroid eye disease.
- Injury and Facial Fractures
When injuries or accidents happen, patients are often rushed to multi-specialty hospitals. However, once life-threatening injuries are stabilized, or absent, immediate attention to the face, and particularly the eye region is important. Trauma can affect any structure of the eyelid, eyeball and the surrounding bones (fractures) depending upon the mechanism and force of injury. Eyelid is a delicate and important structure, and if injured, needs meticulous placement of stitches to preserve its normal shape and function. Injury to the tear ducts (canaliculus) within the eyelids require special placement of silicone tubes within them to keep them open while the injured eyelid heals. Fractures of the bone surrounding the eye (orbital walls) may cause the eye to sink back into its socket, lead to a facial deformity, poor eye movement, or loss of vision. More extensive injuries to facial bones may require a maxilla-facial surgeon to be one of the trauma team member.
A thorough examination is required to find out if the eyeball and surrounding structures are injured. This has to be followed by immediate repair of injured tissues by multispecialty approach by more than one eye specialist. The outcome of trauma repair entirely depends upon extent and severity of injury. Treatment may be needed in stages, and healing may continue for months. Health insurance will cover the costs of trauma repair.