Oculoplasty is also known as oculoplastic surgery, which involves the plastic surgery of an eye. It involves the repair and management of structures related to the eyes like brow, socket and tear ducts. Oculoplasty also deals with nerves which send a message to the brain, the muscles that move the eyeball and provide nutrition to the eye. Oculoplasty can either be purely cosmetic or can be used to reconstruct the structures surrounding the eyeball. Eyelift is also known as blepharoplasty and brow lift also fall under the oculoplasty.
Oculoplasty treats many conditions that are mentioned below:
- Blocked tear ducts: Although most common in infants, adults can also get blocked tear ducts as they age or from trauma, infection, and tumors.
- Cancer and Growths: This refers to tumors/lesions around the eye that will be removed
- Ectropion: In this condition, the eyelid folds outward from the eye.
- Entropion: This condition occurs when the eyelid folds inward toward the eye.
- Injuries: This refers to a trauma that can lead to various aforementioned conditions
- Ptosis: In this condition, one or both upper eyelids droop over the eye causing cosmetic and functional issues.
- Thyroid Eye Disease (TED): Thyroid conditions may sometimes cause issues in the eyes. Diseases such as Grave’s disease may cause problems in the eyes that require surgical intervention.
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Advantages of Oculoplastic Surgery
Oculoplastic surgery produces positive patient benefits. Generally, the patients do not report much discomfort during this procedure and postoperative recovery. Mostly these surgeries are free from any kind of complications. These surgeries improve quality of life as reported by most patients. These procedures include:
- External Dacryocystorhinostomy (DCR), which restores the flow of tears
- Ectropion repair, which is the surgical correction of eyelids that turn outward
- Entropion repair: In this surgery, patients are treated for eyelids that fold towards the inside
- Ptosis repair: When the upper or lower eyelid droop, oculoplastic surgery provides a solution that corrects this problem.
These surgeries benefit patients both cosmetically and functionally. The lids are elevated to their normal position allowing better peripheral vision and the eyes are given a refreshed more youthful appearance.
- A patient should avoid the use of blood thinners like aspirin or alcohol, for a couple of weeks before surgery.
- Smoking patients must stop smoking 2-3 weeks prior to surgery, as smoke can easily affect eyes and may interfere with the healing process.
- Routine tests are done to make the surgery a safe option. This may include:
- Complete Blood Count (CBC)
- Prothrombin Time (PT)
- Electrolyte panel
- Partial Thromboplastin Time (PTT)
- Magnetic Resonance Imaging (MRI),
- Chest Radiograph
- Orbital Computed /Tomography (CT)
- Imaging tests and X-rays
- The patient is given general anesthesia (in case of children or invasive surgery such as orbital surgery) or local anesthesia or MAC anesthesia which includes local anesthesia and intravenous sedation. Use of local anesthesia or MAC anesthesia ensures quicker post-operative recovery
- In eyelid surgery called Blepharoplasty, incision with a blade is made along the natural line of the upper eyelid. The skin is detached from the underlying tissue to remove the superfluous fat, skin and muscle. The upper eyelids are then sutured to seal the incisions. The lower lids may not be sutured depending on the technique used for surgery. The procedure lasts nearly 2 hours if both upper and lower eyelids are operated together.
- In Tear Duct surgery, an incision is made through the nose or the inside corner of the eye and nose. The surgeon creates a new drain opening directly into the nose for the tears to flow from the blocked sac. The new drain may be kept open by a stent for some time.
- Orbital Surgery requires a CT scan and fine needle aspiration done by the surgeon prior to the surgery to determine the approach to be taken for orbital surgery. Depending on the size, location and extent of disease, there are various types of orbital surgeries. Some of these may not require an incision or small or large incisions may be needed. Damaged tissues are removed carefully while preserving functionality and vision of the eye.
- Pediatric Oculoplastic surgery is performed under general anesthesia to correct congenital tear duct obstruction or ptosis.
- It is very important to schedule someone to drive the patient home after surgery
- The driver must accompany for at least 8-12 hours to assist if any immediate complications happen
- The patient should not return to work for some time after surgery.
- Typically, the patient should have 1-2 weeks off from work after the procedure
- Suggested use of cold packs will help reduce swelling and pain.
- Avoid raising your blood pressure for approximately 3 weeks
- Avoid strenuous exercise or stressful activities
- Avoid alcohol and medications that thin the blood (like aspirin) for at least a week.
- Avoid sleeping with your head too far back, it could lead to fluid interfering with the healing process
- The patient must be careful while bathing and follow the instructions meticulously regarding the changing of dressings on the eye.
- Avoid infection with proper hygiene.
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Risks involved in Oculoplasty
The surgical area will likely bruise and swell at first, with discomfort. Surgery might lead to these temporary side effects:
- Increased tear production from the eyes
- Sensitivity to light
- Sensitivity to wind
- Double vision
- Signs of infection: Abnormal discharge from the wound area with blood along with pus.
- Uncontrolled pain that might not be mitigated by over-the-counter pain relievers.
- Feeling nausea.
- Damage to the cornea of your eye: Vision gets worse when started to improve with flashing lights or dark spots.
- Abnormal wound healing
- Improper incision closure
Factors Affecting the cost of Oculoplasty
- The type of anesthesia
- Hospital Stay
- Surgeon fee
- Types of procedures, single or dual i.e., one eyelid or two eyelids