Oculoplastic Surgeries

Types of Oculoplasty

We offer many types of oculoplastic surgeries which are designed to address medical conditions and/or cosmetic concerns.

Ptosis

Ptosis is the medical term for drooping of the upper eyelids. Drooping of the upper eyelids can cause a reduction in the field of vision when the eyelid obstructs the pupil. Children with ptosis may develop amblyopia or may cause developmental delay from limitation of vision. People with ptosis will complain more at the end of the day or when tired.  

People can be born with ptosis, while adults develop ptosis as a result of aging, prior surgery, or long-term contact lens use. Drooping of eyelids are usually caused by loosening or stretching of the muscle and tendon that are responsible for elevating the eyelid.

Ptosis can be corrected surgically by reattaching or shortening the stretched muscle in order to elevate the eyelid to restore normal field of vision. Recovery from ptosis surgery is usually quite rapid, and patients find themselves returning back to work within few days.

Tearing disorder

The lacrimal gland is responsible for the production of tears so as to keep the eye moist for healthy function. After tears are produced, blinking serves to spread tears over the surface of the eye, and it pumps excess tears into the tear drainage system. That being said, it’s important to note that any dysfunction in this process may lead to too much or too little fluid in the eye. The eye may water excessively either due to dryness or obstruction of the outflow of tears from the eye. 

The most common cause of tearing is a reflex, which occurs from the drying of the cornea or surface of the eye. If the lacrimal gland fails to produce enough tears, the surface of the eye begins to dry out. This results in symptoms of burning, tearing, and irritation. Lubrication will help control the drying and irritation and secondary reflex tearing. Dry eye can be treated with lubricating drops or when lubrication does not relieve the symptoms, punctal plugs can be placed in the tear drainage system for relieve.

Obstruction of the tear drainage system can also cause the tears to back up and roll down the cheeks. Treatment can be as simple as using eye drops, a minor procedure in the clinic, or may require surgery in the operating room. Lacrimal surgery (Dacryocystorhinostomy) is required to explore and reconstruct any portion of the system depending upon the location of the closure or obstruction. 

Eyelid Malposition (Eyelids “turn in or out”)
Ectropion Repair

Ectropion is a condition in which the lower eyelid is “rolled out” away from the eye, or is sagging away from the eye. The sagging lower eyelid leaves the eye exposed and dry. If ectropion is not treated, the condition can lead to chronic tearing, eye irritation, redness, pain, a gritty feeling, crusting of the eyelid, mucous discharge, and breakdown of the cornea due to exposure.

Entropion Repair

Entropion is a condition in which the eyelid is rolled inward toward the eye. It can occur as a result of advancing age and weakening of certain eyelid muscles. A turned-in eyelid rubs against the eye, making it red, irritated, painful, and sensitive to light and wind. If it is not treated, the condition can lead to excessive tearing, mucous discharge and scratching or scarring of the cornea. A chronically turned-in eyelid can result in acute sensitivity to light and may lead to eye infections, corneal abrasions, or corneal ulcers.Both ectropion and entropion can be repaired with surgical procedures designed to return the eyelid to its natural position.

Eyelid deconstruction

Eyelid reconstruction is often required following trauma or tumor excision. Depending on the degree and location, reconstruction can be performed using a variety of tissue flaps and grafts.

Eyelid lesions and skin cancer

The eyelid skin is the thinnest and most sensitive skin on your body. As a result, this is often the first area on your face to show change from sun damage and aging. Unfortunately, sun damage and other environmental toxins not only cause the skin to age but also can cause serious damage.

Skin cancer of the eyelids is relatively common and several types exist. The presence of a nodule or lesion on the eyelid that grows, bleeds, or ulcerates should be evaluated. This involves examination and, sometimes, a biopsy. Any suspicious areas need to be evaluated and may require a biopsy to confirm the diagnosis of a skin cancer.

Treatment of eyelid skin cancer involves the complete removal of the tumor followed by reconstruction of the eyelid. Complete removal of eyelid cancer is important to minimize the likelihood of a recurrence or spread of the cancer. The oculoplastic surgeon may remove the tumor and have the pathologist check the tissue margins and frozen sections, to be sure that the tumor is completely removed.

Another method involves a dermatologic surgeon excising the tumor, using Mohs’ technique, to ensure the total removal of the cancer. After the cancer has been completely removed, reconstructive surgery by an oculoplastic surgeon is usually necessary to preserve the function of the eyelid and obtain the best cosmetic appearance possible.

Blepharoplasty (eyelid surgery)

Your eyes are often the first thing people notice about you and are an important aspect of your overall appearance. As we age, the tone and shape of our eyelids can loosen and sag. Heredity and sun exposure also contribute to this process. This excess puffy or lax skin can make you appear more tired or older than you are.

Eyelid surgery or blepharoplasty can give the eyes a more youthful look by removing excess skin, bulging fat, and lax muscle from the upper or lower eyelids. If the sagging upper eyelid skin obstructs peripheral vision, blepharoplasty can eliminate the obstruction and expand the visual field. 

Upper Blepharoplasty

Upper eyelid blepharoplasty is a surgical procedure that removes excess skin and fat in the upper eyelids. The excess skin may interfere with vision or result in eyelid fatigue. An incision is made in the natural crease of the eye and skin, muscle, and fat are removed.

Lower Blepharoplasty

Lower eyelid blepharoplasty is a surgical procedure that removes excess skin, muscle and fat from the lower eyelids. The lower eyelids may become droopy with the appearance of “bags” under the eyelids. A lower eyelid blepharoplasty is directed at removing the excess skin, muscle, and fat through a skin incision below the eyelid margin. The fat may be removed through an incision inside of the lower eyelid without the need for a skin incision.