Oculoplastic Surgery
This information is of a general nature only and is for public information and education. Your individual problem needs to be assessed by your family doctor who will advise you on appropriate further steps.
Oculoplastic Surgery deals with surgery of the eyelids, the lacrimal system (the tear gland and ducts) and the bony orbital cavity. This section of surgery has developed over the last 75 years, with significant contributions from Ophthalmic and Plastic and Reconstructive Surgeons and is now a well established subspecialty.
In the eyelids, the problems dealt with include trauma (injuries), malposition of the eyelids (ectropion or outward displacement, entropion or inward displacement) and blepharoptosis (drooping of the upper eyelids, either from birth or more commonly, with advancing age) and tumours (both cancerous and non-cancerous).
In the lacrimal system, the problems dealt with include trauma and tumour as well as problems with the drainage of tears.
In the bony orbit, problems dealt with include trauma and tumour.
A major area of work now involves craniofacial surgery where well established techniques are available to shift the whole bony orbit inwards or outwards in a major birth defects of the bones of the skull and face.
Cosmetic Oculoplastic Surgery is now a popular part of Oculoplastic Surgery and is used to correct drooping or displaced structures. The emphasis nowadays is towards restoration of tissues to original sites rather then a removal.
Blepharoptosis
"My eyes feel tired after I read for a while and I cannot keep them open by the end of the day" is a common complaint in some patients. Patients tend to consult their doctor, wondering if they need cataract surgery? However the problem is often due to 'Blepharoptosis' or drooping of the eyelids.
The eyelids have two major groups of muscles, those that close the eye and those that open the eye. While closing the eye is usually a voluntary act, opening of the eye is almost automatic, ie one does not consciously open the eyes as the upper eyelids stay elevated to permit one to see out of one eye. Blepharoptosis can be congenital (a birth defect), but more commonly, it is due to aging. In some patients, the problem is seen in their thirties and forties but more commonly it is seen in patients who are older.
The main cause of the problem is a stretching of the muscle which draws up the eyelids like a curtain. In addition, the attachment of the muscle to the eyelid is also frayed. Corrective surgery, ie Ptosis Surgery, involves shortening and reattaching the muscle. In addition, excess upper eyelid skin, muscle, and fat is removed, all of which makes the eyelid lighter and hence easier for the eyelid to be maintained in a good position. The furrows in the forehead will decrease as the forehead muscle no longer needs to work overtime doing the work of the eyelid lifting muscle.
Commonly, the problem involves both sides and surgery is done on both sides simultaneously or one after the other, with the worse side done first.
