Oculoplastic surgery is a form of eye surgery that aims to treat problems with the eyelids, tear drainage system and eye socket. The procedure can either be either cosmetic or reconstructive.
Reconstructive or functional oculoplastic surgery improves the function of the structures around the eye. People with functional eyelid problems can experience difficulties with their vision or field of vision, have excessive tearing, pain and/or discomfort.
Oculoplastic surgery is required when patients experience eye problems such as droopy eyelids, thyroid eye disease and excessive tearing.
Droopy upper eyelid problems, or ptosis, are usually caused by excess skin in the upper eyelid. This extra skin can block the eye’s field of view and create vision problems. Lower eyelid problems can also affect vision, particularly in cases of ectropian and entropian lower eyelids, when the lower lid falls away from the eye or turns inwards towards the eye respectively.
When a patient suffers from thyroid eye disease, their eyes become inflamed and swollen and begin to bulge. This can cause watery eyes, light sensitivity, pain and blurred vision that requires oculoplastic surgery to repair.
Excessive tearing, which may be due to poor tear drainage in the eye, may also require surgery to repair.
Oculoplastic Surgery at Somerset Eye largely depends on what eye problems a patient is suffering with. Though sedation can be requested, eyelid procedures are generally performed under local anaesthetic. Tear drainage and orbit, or eye socket, surgery is usually performed under general anaesthetic.
A droopy upper lid is most commonly repaired by shortening the muscle in the upper lid, which can stretch with age, and reattaching it to the firm structure in the eyelid. A blepharoplasty can also be performed to remove the excess skin in the upper lid.
To repair eye problems in the lower eyelid, either an ectropian repair or entropian repair is performed. An ectropian repair shortens lower lid when it falls away from the eye while an entropian repair tightens and strengthens the lid such that it sits in its normal position.
Tear drainage in cases of excessive tearing can be improved by performing a dacryocystorhinostomy (DCR). This is performed when there is a blockage of the passage that takes the tears down to the nose and involves making a direct connection between the tear sac and the nose. If there is no absolute blockage of the passage, drainage can still improve with a DCR. Alternatively, if the eyelids are lax, tightening the lids may help improve the drainage of tears.
Thyroid eye disease can be treated with eyelid surgery or decompression surgery. Decompression surgery will create more space behind the eye and is usually performed when thyroid eye disease puts pressure on the eye’s nerves. This surgery helps the eyes to close better. Eyelid surgery also helps improve the comfort of the eye and eye muscle surgery can be performed if vision is impaired by thyroid eye disease.