Oculoplasty is the art and science of plastic surgery around the eye. The Oculoplasty subspecialty at The Himalayan Eye Institute deals with the various diseases of the eyelids and lacrimal system. Our Oculoplastic surgeon routinely performs procedures like DCT, DCR, Ectropion, Entropion, Lid surgery &Botox injections to treat vast spectrum of eye disorders.
Watery Eye (Lacrimation / Epiphora)
A watery eye is caused by over production of tears due to irritation by in-growing lashes, infection, eyelid disease or an obstruction in the drainage of tears in the eye. The treatment depends on the cause of the disease. For example, if the lower eye lid is sagging away from the eye, eyelid will be repositioned through surgery. If the drainage pathway of tears is blocked, a DCT/DCT surgery may be required.
Ptosis or ‘Drooping’ of the eyelid can be present from birth or develop later in old age. It is a cosmetic blemish but if severe, it restricts vision as well. The treatment in majority of cases consists of surgical correction. Surgery involves either strengthening the muscle, which elevates the lid, called LPS resection, or lifting up the lid with the help of a graft.
When ptosis occurs in adults, it may be the result of a systemic disease, such as myasthenia gravis, which can be treated medically. It can also follow muscle or nerve damage in other parts of the body, or tumors of the lid. When ptosis occurs suddenly in one eye, disease of the brain itself must be considered, and the patient should be seen at once by a neurologist.
Smiling, frowning, squinting and even chewing - basically any facial movement can eventually lead to one of the most common signs of aging: wrinkles. They can make you appear tired or even angry when you are not. One of the quickest and safest remedies to remove wrinkles is an injection of Botox.
Botulinum toxin can be used as a wrinkle treatment to smoothen:
Botulinum toxin can be combined with other cosmetic skin procedures such as chemical peels, dermal fillers or microdermabrasion to further improve your results. This combination of therapies can even help to prevent the formation of new lines and wrinkles.
The Ocular Prosthesis service is available at The Himalayan Eye Institute, for the management of patients with eviscerated, enucleated socket (removed eye) and phthisical eye (shrunken eye). These problems are managed cosmetically by prosthesis.The institute offers both Customized Prosthesis, i.e., preparing eye shells for the patients according to their socket dimensions; and also, there are Stock Eyes of readymade eye shells.
For Eyelids:
For Lacrimal Gland (Tear Gland)
For Eye Socket
Cosmetic procedures:
Blepharoplasty is a surgical procedure that removes excess tissues (skin, muscle or fat). It can be performed on the upper eyelid, lower eyelid or both. Sometimes excess upper eyelid tissue obstructs the upper visual field or can weigh down the eyelid tiring the eyes. The procedure is also used to improve facial appearance by making the area around the eyes firmer and eliminating sagging skin under the eyes.
Apart from being cosmetically unacceptable, any irregularity of the lid margin is functionally detrimental to the eye, as lid defects may fail to cover the cornea fully and provide adequate lubrication. Our oculoplastic surgeon repairs the injury in a way to make the lid as close to normal as possible.
Normally tears from the eye drain to the nose through the lacrimal passage. In case of any blockage in this passage, watering results. The causes can be incomplete development, seen in young children, or infection, which occurs in adult life. Treatment varies from performing a relatively simple procedure like ‘probing’ the pathway to open it, to more complex surgery of fashioning an alternative pathway to drain the tears to nasal cavity. This procedure is known as dacryocystorhinostomy (DCR). Sometimes, when an alternate pathway creation is not possible, the infected lacrimal sac may need to be removed by dacryocystectomy (DCT) to prevent repeated infections of the sac (dacrycystitis).
Lid margin abnormalities - Entropion
In a condition known as entropion there is inward turning of the eyelids, causing the eyelashes to scratch the cornea and produce irritation. Tearing and secondary infections as well as an unpleasant looking eye cause the patient to seek medical care. Entropion may be the result of spasm or secondary contracture or strictures from burns, injury or trachoma infection. It may involve the upper or lower lids. An adhesive tape applied to the skin of the lid temporarily may straighten the lid and relieve the annoying symptoms. Corrective surgery is usually required for a permanent cure.
Lid margin abnormalities - Ectropion
Ectropion is the opposite condition, and the lower lid usually turns away from the eyeball. Ectropion may be due to laxity of the tissue in elderly people or to paralysis of the seventh cranial nerve (the nerve which controls the facial expressions), which causes the weakness of the muscles of the lid. It may also follow cuts, infections, or burns of the lids and face that heal poorly; the resultant scar tissue forms adhesions that cause the lids to turn out. Besides being cosmetically unpleasant, ectropion is accompanied by troublesome tearing and infection. Treatment is surgical rotation of the lid margin and its alignment with the eyeball.
Lid margin abnormalities - Trichiasis
Trichiasis is a condition in which there is misdirection of eyelashes. If the eyelashes turn in toward the eyeball and scratch the cornea, they produce a sensation like a foreign body. This condition may result from trachoma (an eye infection), burns or injuries to the lids. Removal of the offending lashes or corrective plastic surgery on the lid relieves the symptoms.
The child was brought to us from a village near Kurseong, Darjeeling with complaints of redness and pain in eyes. On slit lamp examination, our eye surgeon, Dr. Shyamal Saha, found leeches in the eyes of the patient. The boy has a history of playing under the bushes besides a puddle. Surgery was performed to remove the leeches successfully and the eyes of the little boy were saved from these blood sucking parasites.
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