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This is the subject which deals with plastic surgery and reconstruction of eyes and related parts of the eye along with the face in cases where the problem is by birth or acquired. It aims at improving function, comfort and appearance. These procedures include repair of droopy eyelids, repair of tear duct obstructions, orbital fracture repairs and removal of tumors in and around the eyes.

Many people develop droopy eyelids, or “ptosis”, as they age. As the eyelid droops, vision may be impaired due to the eyelid covering the front of the eye The most common cosmetic problem is drooping of the upper eyelid (ptosis) which if too severe can on occasions lead to lazy eye (amblyopic) in children. The bony orbit as well as the lids could be site of injury related damage. The orbit can also harbour tumors and lead to forward protrusion of the eye (proptosis).

The eye socket contains the muscles that move the eye and the bones and fat that protects it. Occasionally, the socket may be affected by injury, inflammation, tumors, or by certain medical disorders.

Repair of tear duct obstructions prevents tears from running out of the eyes and down the face, in some cases without even an incision. (Endonasal approach).

Repair of traumatic orbital fractures may prevent double vision as well as a sunken eye appearance.

Droopy eyebrows being raised through tiny incisions hidden in the hairline.

Symptoms of oculoplasty

Droopy eyelids or eyebrows

Eyelids turning in or out

Excessive watering due to tear duct or tear sac problems

Growths or Tumors

Excessive blinking or uncontrollable eye closure

Twitches

Excessive wrinkles / skin folds around eyes

Thyroid imbalance

Paralysis affecting the face

Loss of eye due to injury or infection wherein artificial eye fitting is needed, to improve appearance

When to go for Oculoplasty ?

People of any age group can have problems with the areas around the eyes. Some conditions can be present in children, as birth defects, or appear in early childhood. These conditions in children need to be addressed early as they may hamper visual development, and lead to lazy eye (amblyopia).

Aging and the Eyelids

Many people develop droopy eyelids, or “ptosis”, as they age. As the eyelid droops, vision may be impaired due to the eyelid covering the front of the eye. In addition to droopy lids, many people also develop excess skin and fat in their upper eyelids as they age.

Tear Drainage Problems

There are many reasons for people to have watery eyes. In some cases, surgery may be able to reduce the amount of watering. The tears normally drain from the surface of the eye through the eyelids and into the nose. If the drainage system is blocked, the tears cannot leave the surface of the eye and may spill onto the cheek. Your surgeon will determine whether the drainage system is working properly or if a blockage is present.

Eyelid Malposition

The eyelids are designed to protect the eyes. As we age, the lids may stretch and pull away from the surface of the eye, and may also turn in (entropion) or turn out (ectropion). This may cause the surface of the eye to become irritated and may cause the eye to water. Surgery can often restore the normal position of the eyelid.

Skin Cancers of the Eyelid

We are all at risk for developing skin cancer. Fair skin and increased exposure to sunlight increases this risk. The eyelids and face are common locations for skin cancers to develop. The most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. You should inform your doctor about any growths on the eyelid or face that you are concerned about, whether they be new or old, especially if they have increased in size.

The Orbit (“Eye Socket”)

The eye socket contains the muscles that move the eye and the bones and fat that protects it. Occasionally, the socket may be affected by injury, inflammation, tumors, or by certain medical disorders.

Anophthalmia (Loss of an Eye)

The loss of an eye, understandably, is very difficult for the patient. The oculoplastic surgeon is one member of a team to assist with this transition and assist in ensuring the best possible outcome. After the eye has been removed, an implant is placed in the eye socket and the muscles that moved the eye are usually attached to the implant. After the socket has healed, an “ocularist” who fits them with prosthesis sees the patient. This is referred to as a “glass eye”, although they are not glass and have excellent cosmetic appearances. Patients typically continue to see the oculoplastic surgeon periodically after surgery in order to ensure the health of the socket.

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