Oculoplastics includes surgeries to the eyelids, lacrimal and orbital areas of the eye.
Eyelid conditions include:
Blepharitis: common and not usually vision threatening. It is inflammation of the eyelids, sometimes combined with blockage of the Meibomian glands. May be associated with other skin conditions such as acne rosacea or dermatitis.
Blepharospasm: condition where patients experience involuntary and excessive eyelid blinking. The exact cause is unknown although sometimes it may be due to dry and irritated eyes, or stress. Treatment varies depending on the severity, more severe cases are treated with BOTOX injections.
Ectropion: the outward turning of the lower eyelid. The major causes include ageing, facial palsy, prior surgery or sun damage. Ectropion treatments include surgery to reposition the eyelid.
Entropion: the inward turning of the lower eyelid. The major causes are ageing, scarring of the inner layer of the eyelid due to inflammatory disease, long-term use of some eye drops and congenital malformation of the eyelid structures. Surgery is performed to reposition the affected eyelid.
Eyelid skin tumours: a tumour is any type of abnormal growth in the body. There are many types of benign and malignant skin tumours. Malignant tumours should be removed, which is normally done surgically (excision), although occasionally other treatments like radiotherapy and chemotherapy are also used.
Lacrimal conditions include:
Lacrimal obstruction: blocked tear ducts causing the eyes to become watery and sometimes sticky. Most cases of confirmed obstruction will require an operation to relieve symptoms once they occur.
Orbital conditions include:
Thyroid eye disease: TED is an autoimmune condition where the body’s own immune system attacks the tissues of the thyroid gland and the eye socket.
Symptoms include inflamed tissues around and behind the eye, which become swollen and congested therefore causing red eyelids, bulging/protruding eyes and eyelids to open too far. The swelling of the eye muscles reduces their ability to contract and relax thereby affecting eye movements. If the muscles get very swollen, they can compress the optic nerve at the back of the eye socket causing vision loss.
Treatment includes orbital decompression involving the removal of some of the bony walls of the orbit to create more space for the inflamed orbital tissues and allowing backward movement of the eyes in the eye-sockets. This is done to remove the pressure off the optic nerve and allow recovery of sight, or to improve cosmetic appearance. Other treatment includes prednisolone therapy – prednisolone is a form of steroid that has been an effective treatment for TED.