Faq Oculoplasty
Specialised Oculoplasty Services
Orbit and Oculoplasty is a newly emerging sub-speciality in the field of Ophthalmology. The focus of the Orbit and Oculoplasty services is on the evaluation and management of Orbital and adnexal disorders. The blemish created by lid abnormalities and socket deformities are corrected.
- Correction of Inturning(Entropian)/Outturning(Ectropion)/eyelids
- Electrolysis for misdirected eyelashes(Trichiasis)
- Ptosis Surgery
- Surgical resection of growths on lids
- DCR (Dacryocystorhinostomy), DCT(Dacryocystectomy), Probing
- Enucleation/Evisceration with implant
- Socket reconstruction with or without AMG/MMG
- Rehablitation of patients of Exentration with Orbital Prosthesis (Facial+Prosthetic eye)
- Management of Anophthalmia (Absent eyeball since birth or after surgery)
- Management of Shrunken eyes (Phthisis & Atrophic Bulbi) with Custom Made Artificial Eye Botox treatment for facial twitches & frown lines
Botox treatment for facial twitches & frown lines
Common EyeLid Problems
1. Stye (External Hordeolum)
2. Hordeolum Internum
3. Chalazion
4. Blepharitis
5. Entropion
6. Ectropion
7. Trichiasis
8. Ptosis
9. Lid tumors
Stye (External Hordeolum)
What is Stye (External Hordeolum)?
A localized infection or inflammation of the eyelid margin involving hair follicles of the eyelashes or meibomian glands.
Stye (Upper Eyelid)
What are Symptoms of Stye?
• Severe pain which is sharp throbbing, feeling of fullness or heaviness and feeling of heat
• Tenderness (increase in pain on touching swelling/affected area)
• Pain subsides on escape of pus
What are signs of Stye?
• Starts usually as edema of the lids with chemosis
• Yellow pus point appears on the lid margin around the root of a lash at the most prominent part of the swelling
• Starts usually as edema of the lids with chemosis
• Yellow pus point appears on the lid margin around the root of a lash at the most prominent part of the swelling
What is the treatment of Stye?
1) Systemic
• Antibiotic
• Anti-Inflammatory Analgesic
• Supportive
• Treatment of associated systemic predisposing cause
2) Local
• Hot Fomentation
• Local broad spectrum antibiotic drop and ointment
• Evacuation of pus when pus points, sometimes epilation may be required before evacuation of pus (lid margin/ lesion should never be squeezed).
Hordeolum Internum
What is Internal Hordeolum?
• Hordeolum Internum is a suppurative inflammation of meibomian gland.
• It may be due to secondary infection of meibomian gland or it may start to begin with as suppurative infection of meibomian gland.
• This condition is more symptomatic than stye, the gland is larger and is located in fibrous tarsal plate.
Internal Hordeolum
What are symptoms of Internal Hordeolum?
• Pain, which may be severe throbbing
• Swelling, which is away from lid margin
• Pus pointing either at the lid margin or on the palpabral conjunctiva.
What are signs of Stye?
• Swelling of affected lid, due to associated cellulitis
• Swelling is more marked about 4-5 mm from lid margin.
• Tenderness
• Palpabral conjunctiva over the swelling is congested a pus point may be visible
• Pus point may be visible at the lid margin
What is the treatment of Intertnal Hordeolum?
Medical treatment is similar to treatment of Hordeoulm externum i.e.
1) Systemic
• Antibiotic
• Anti-Inflammatory Analgesic
2) Local
• Hot Fomentation
• Local broad spectrum antibiotic drop and ointment
Sometimes it turns into chronic granuloma i.e. Chalazion
Chalazion
What is Chalazion?
• Chalazion is also called tarsal cyst or meibomian cyst
• Chalazion is chronic inflammatory inflammatory granuloma of meibomian gland
• Seen in adults more often as multiple lesions occurring in crops
Chalazion
What are symptoms of Chalazion?
• Hard painless swelling little away from lid margin
• Swelling increases gradually in size without pain
• Small chalazia are better felt than seen
• Multiple lesions and large chalazion may be associated with inability to open eye fully.
What are signs of Chalazion?
• Painless swelling 4-5 mm away from lid margin. Swelling is hard
• On conjunctival side it appears red or purple. In long standing lesions it appears grey. In old lesion granulation tissue turns into jelly-like mass
• Chalazion may become smaller over the period of time , but complete resolution may occur only rarely
• Sometimes the granulation tissue is formed in the duct and project at the intermarginal strip as a reddish grey nodule.
What is the treatment of Chalazion?
• Intralesional injection of Triamcinolone Acetonide may help in resolution of chalazion
• Supportive
• Incision & curette of chalazion is indicated in cases when it causes disfigurement and mechanical ptosis due to its weight.
• Swelling remains for few days after surgery as the cavity is filled by blood.
• Post-operatively analgesic may be needed systemically. Local antibiotic drop and ointment for 1 to 2 wks
Blepharitis
What is Blepharitis ? |
Blepharitis is chronic inflammation of lid margin occurring as true inflammation or as simple hyperaemia.
1) Anterior
2) Posterior
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What are the symptoms and signs of Anterior Blephritis? |
It occurs in two clinical forms:-![]() A. Seborrhoeic or Squamous Blepharitis:-
Symptoms:-
Treatment:-
Symptoms:-
Signs:-
Treatment:-
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What are the symptoms, signs & treatment of posterior Blephrites? |
It is inflammation of meibomian duct opening at intermarginal strip
It occurs in two clinical forms:-
Treatment:-
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Entropion
What is Entropion?
It is the medical term used to describe sagging and inward turning of the lower eyelid and eyelashes. The margin of the eyelid and the eyelashes invert (turn in)
What are the symptoms of Entropion?
Inturn eyelidmargins and eyelashes rub against the cornea. This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, irritation of the eye, chronic redness and corneal damage.
What are the causes of Entropion?
• Age related: Most cases of entropion are due to relaxation of the tissues of the eyelid as a result of aging.
• Some cases result from scarring of the conjunctiva caused by chemical and thermal burns, trauma, conjunctival cancers, or previous eyelid surgery.
• Rarely entropion can be present at birth if the eyelids do not form properly.
What is the Treatment of Entropion?
• Prior to surgery, the eye can be protected by taping the lower lid down and using lubricating drops and ointment.
• Entropion should be repaired surgically before the rubbing damages the cornea by causing infection and scarring.
• In some cases, sutures can be placed through the lower eyelid until more definitive surgery can be performed.
• In rare instances a special injection(BOTOX) may injected to bring the lid into its normal position.
Please tell me something about surgery and post-op care?
• The surgery to repair entropion is usually performed under local anesthesia .
• In most cases, your doctor will tighten the eyelid and its attachments.
• You may have a patch overnight and then will commonly use an antibiotic ointment for about a week.
After your eyelids heal, your eye will feel comfortable and you will no longer have the risk of corneal scarring, infection, and loss of vision.
Ectropion
Ectropion
What is Ectropian?
It is the medical term used to describe sagging and outward turning of the lower eyelid and eyelashes. The margin of the eyelid and the eyelashes evert (turn out).
What are the symptoms of Entropion?
Turn out margin of the eyelid and the eyelashes can lead to excessive tearing, crusting of the eyelid, mucous discharge, irritation of the eye and chronic redness.
Ectropion of Lower Eyelid
What are the causes of Ectropion?
• Age related- Most cases of ectropion are due to relaxation of the tissues of the eyelid as a result of aging
• Some cases result from scarring of the eyelid skin caused by chemical and thermal burns, trauma, skin cancers, or previous eyelid surgery.
• Paralysis of the face is another common cause of ectropion.
• Rarely ectropion can be present at birth if the eyelids do not form properly.
What is the treatment of Ectropion?
• Prior to surgery, the eye can be protected by using lubricating drops and ointment
• Ectropion should be repaired surgically before the rubbing damages the cornea by causing infection and scarring.
• When ectropion is due to scarring of the eyelid then skin grafting is required.
• In some cases, sutures can be placed through the lower eyelid until more definitive surgery can be performed.
Please tell me something about surgery and post-op care?
• a. The surgery to repair ectropion is usually performed under local anesthesia .
• b. In most cases, your doctor will tighten the eyelid and its attachments.
• c. You may have a patch overnight and then will commonly use an antibiotic ointment for about a week.
After your eyelids heal, your eye will feel comfortable and you will no longer have the risk of corneal scarring, infection, and loss of vision.
Trichiasis
What is Trichiasis?
Trichiasis means misdirected eyelashes .In this position of the lids are normal.
What are the symptoms of Trichiasis?
Misdirected eyelashes rub the cornea. This rubbing can lead to excessive tearing, irritation of the eye, chronic redness and corneal damage.
What is the treatment of Trichiasis?
a. Electrolysis for misdirected eyelashes.
b. In severe cases lid surgery may be required.
Ptosis
What is Ptosis?
Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes.The ptosis may be mild – in which the lid partially covers the pupil; or severe – in which the lid completely covers the pupil.
When does Ptosis occur? |
Ptosis can occur at any age.
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What are the causes of Ptosis? |
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What is the treatment of Ptosis? |
Ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle.
Congenital Ptosis :
Acquired Ptosis:
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Lid Tumors
Watering from the eye.
What are the causes of watering from eyes? |
1) Emotions
2) The common causes are either due to increased production of tears or deficient drainage of tears.
The eye has its drainage system called the lacrimal drainage system. A block along the drainage system is referred to as nasolacrimal drainage obstruction (NLDO). |
1) When this passage is blocked since birth then it is called congenital NLDO.
What is thetreatment in acute dacryocystitis?
2) Following a block the accumulated tears may be a nidus for infection and when infected the condition is called acute dacryocystitis. What is thetreatment in acute dacryocystitis? Systemic
Local
3) When the infection is low grade then there are changes within the walls of the lacrimal system and a chronic dacryocystitis occurs. What is the treatment of chronic dacryocystitis? Treatment options:-
Which procedure to choose? Every procedure has its own merits and demerits.
However your consultant will assist you in selecting the best procedure suited for you. |
What are the types of NLDO? |