Oculoplastic and Orbital Surgery: A Detailed Study

Oculoplastic and Orbital surgery is a kind of plastic surgery that helps in the removal of blockages that causes problems in vision.

It is an art of plastic surgery treatment or a cosmetic surgery treatment that is performed around the eye i.e, near the eyelids and the structures present around the eyeball. As we know, the eyeball is a small structure that is secured by eyelids and a socket (that holds the eyeball). The doctors who perform this surgery are ophthalmologists who have done specialization in oculoplastic surgical procedures, hence they are called oculoplastic surgeons. It is a very delicate surgery that requires greater skill in order to perform. They have the finest knowledge about the eye and its surroundings. Being eye surgeons, they are ever-ready to handle the most delicate of structures. Due to this combination, oculoplastic surgeons are considered the best to do plastic surgery around the eye.

Need to perform an Oculoplastic and Orbital Surgery:

As our age increases, the eyelids tend to loosen and accumulation of fat also takes place which causes a droopy eyelid. This is a kind of cosmetic surgery that helps in regaining the youthful look of the eyes by removal of excess fat, bulging skin and helps in the maintenance of eye as well as facial structure. These symptoms are ideally seen after a tiresome day or sudden pain in the eyes. Drooping of the eyelid is stretching of the muscle below the eye.

Other conditions:

1) Ptosis: There is drooping of the upper lid. It may be present since birth or might appear later in life. Ptosis is usually corrected by surgery. In this state, the eye appears to be small and there is difficulty in opening the eye. It causes visual problems and a sleepy appearance i.e, the patient’s eyes appear like they are in a sleepy state. It can occur during birth and also due to some eye-related problem or an injury or some neurological problem. The aim of performing oculoplastic surgery in this condition is to elevate the eyelid so that normal vision is restored again.

2) Entropion: In this case, the lower eyelid is turned inward causing itching between the eyelashes and there is a pain in the eyeball. Also, the eyes become consistently wet, causing discomfort. Therapies that help in treating this condition are the usage of skin tapes or Botox or the use of soft contact lenses which prevent rubbing.

3) Ectropion – Ectropion is turning outwards of the eyelid margin, causing redness and watering. In this state, the eyelid is exposed to air, and there is constant irritation in the eyes. It can be treated with the use of lubricating eye drops, ointments and in case of any eye infection, the use of antibiotics is preferred.

Orbital treatment:

• It is used in the treatment of fractures in the eye i.e, any orbital fracture such as an injury within the eye can cause amblyopia as well as blurred vision and double vision. This Oculoplastic and Orbital surgery help the patient suffering from these problems to recover. It is a simple process.
• The presence of tumors in the eye, for example:- a bulging eye is a condition that is caused by an eye tumor that needs to be removed so that it cannot cause further harm to the patient.
• After the removal of the eye, due to some problem or any kind of infection, there is a process through which an artificial eye can be placed. This process is called Ocularistry. It is the art and science of manufacturing an artificial eye. For tailor-made artificial eye, measurements are taken from the patient’s own eye, and a color match is done. Thus the prosthesis fits well, is very comfortable, and looks similar to the patient’s own eye.

Procedures for the Oculoplastic and Orbital surgery:

The most common procedures we perform include:

• Blepharoplasty and eyelid ptosis surgery,
• Orbital fracture evaluation and repair
• Orbital tumor surgery
• Tearing disorders

Blepharoplasty:

It is commonly called a lid lift procedure. In this surgery, excess eyelid skin and eyebrows are taken care of. These occur as a part of the aging process, but droopy eyelids can occur at an early age, it not only affects your facial feature but also causes disturbance to your vision. So, the major aim of this procedure is the removal of the excess eyelids and bulging fat through oculoplastic surgery. This surgery also performs the function of reducing the baggy effect.

Orbital fracture evaluation and repair :

The surgeon who performs this surgery first evaluates the severity of the fracture inside the eye with the help of X-rays and CT scans. Usually, if the swelling around the eye is not major, then surgery is not required and the swelling can be reduced by placing some ice packs on it and also use of antibiotics is suggested. But as the severity increases, and orbital surgery is performed to prevent problems such as double vision, blurred sight, and eyeball problems. It takes about 3 weeks to recover from the orbital surgery.

• Orbital Tumor Surgery:

In this state, tumors that are present in the eye are removed with the help of surgery. Sometimes, due to major problems, the eyeball itself is removed to avoid other complications, then with the help of prosthetics, an artificial eye is placed in the empty socket and the orbitals are also reattached to the artificial eye. It takes some time for the patient to recover from the surgery.

• Tearing disorders:

Usually, the eye must be moist in order to maintain the required pH level of the eye. So tear glands or the lacrimal glands help in the maintenance of eyes when the eyes blink, the tears are spread along with the eye with the help of the eyelid and the tear draining system helps in the removal of excess tears and this maintains the moisture of the eye. Due to dryness or the presence of any obstruction to the tears, there is excessive dryness in the eye. When there is a decrease in tears production by the lacrimal gland, it causes severe pain as well as irritation to the eyes, redness, and drying of the eye.

Another cause of tearing is a hindrance of the outflow of the tears from the eye. In case of proper functioning of the lacrimal gland but the tear drainage system is not functioning, then the tears will back up, causing the tears to roll down the cheek. To create a new drainage path for the tears, either the existing tear drainage system needs to be corrected or the system needs to be bypassed entirely in order.

Effects after the oculoplastic and Orbital surgery:

After this surgery is performed, it takes about 24 days for the entire orbital base to regain its original pace of activity. The patient is not allowed to expose the eyes to bright sunlight and should remain indoors for 2-3 days after the completion of the surgery. Wearing sunglasses is a must for such patients. The healing of the scars that appear after the surgery is most important, as it takes more time to recover almost 6 months in few cases. In oculoplastic surgery, the patient can move out after 10- 15 days, and minimizing the activities can ensure a quick recovery. Oculoplastic and Orbital surgery is not at all painful but can cause sometimes swelling of the eye, which heals itself over a period of time.

The best way to treat your eyes is to visit your eye care professional and get your eyes checked regularly. He will be able to assess the best method of treatment for your eye ailment.

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