Orbital Oculoplasty

This deals with the management of diseases and abnormalities of the orbit (bony cavity enclosing the eye), eyelids and the lacrimal system. The orbit can be the seat of tumors that cause protrusion of the eyeball (proptosis). The lacrimal system drains tears into the nose and could be the site of chronic infection (dacryocystitis).

Treatment and Management Plan

1. Sockets

  • Eviseration & Orbital Implant: Removal of the iris, cornea, and internal eye contents, but with the sclera and attached extraocular muscles left behind. The surgery often includes placement of an implant into the evisceration cavity to maintain appropriate orbital volume.
  • Enucleation & Orbital Implant: Removal of the eyeball, but with the eyelids and adjacent structures of the eye socket remaining.
  • Socket Reconstruction: The surgical reconstruction of an eye socket can be required when an ocular prosthesis no longer fits well or causes discomfort.

2. Lacrimal

  • Syringing, Probing & Intubation: Probing and syringing is usually a quick procedure where a fine probe is passed through the tear duct to clear the blockage or to widen the tear duct.
  • Punctoplasty: Performed to widen the punctal opening and to improve the drainage of tears in patients.
  • Dacryocystorhinostomy (DCR): Procedure that aims to eliminate fluid and mucus retention within the lacrimal sac, and to increase tear drainage for relief of epiphora (water running down the face).

3. Orbit

  • Dermoid Incision: Surgical excision is the treatment of choice in any localization. Surgically remove dermoid cysts.
  • Anterior | Lateral Orbitotomy: A technique used in the management of severe traumatic disruption of the orbital skeleton.
  • Exenteration: Removal of the contents of the eye socket, including the eyeball, fat, muscles, and other adjacent structures of the eye. The eyelids may also be removed in cases of cutaneous cancers and unrelenting infection.

4. Lids

  • Ptosis Repair: Eyelid-lifting muscle (levator) is tightened. In severe ptosis, when the levator muscle is extremely weak, the lid can be attached or suspended from under the eyebrow so that the forehead muscles can do the lifting.
  • Entropian | Ectropian Repair: Symptomatic therapy can be achieved medically using artificial tear ointment or drops, moisture shields or taping of the lower lids. Botulinum toxin injections to the lower lid can be considered. Reconstructive surgery for both is considered in advanced cases where by the eyelids are repositioned.
  • Lid Tumours : Excision and reconstructive surgery is done to remove any tumors. Malignant tumors may require advanced treatment.
  • Tarsorrhaphy : Surgical procedure in which the eyelids are partially sewn together to narrow the eyelid opening. It may be done to protect the cornea in cases of corneal exposure, as a treatment for Graves' ophthalmopathy, Möbius syndrome or after corneal graft surgery.
  • Epilation & Lash Electrolysis : Removal of eye lashes which may be causing corneal abrasions.

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