Eye and Orbital Plastic Surgery (Functional/Reconstructive)

An important aspect of the work that our surgeons perform in the Ophthalmic Plastic Surgery Service is aimed at functional problems of the eye and its surrounding structures, that is, problems that can impair vision or result in poor functioning of the eye.

Ptosis Repair

Ptosis is the medical term for drooping of the upper eyelid(s). Ptosis may be mild to severe. For example, with severe ptosis the lid partially or completely covers the pupil, thus blocking one's field of vision. In most cases, ptosis is acquired due to the aging and drooping of the delicate skin around the eyes.

Orbital Tumors and Inflammation

The orbit contains the bones of the eye socket, the eyeball, the eye socket muscles, the optic nerve and the surrounding fat. Any of these structures may degenerate into a tumor. Orbital tumors can potentially affect both adults and children. The evaluation of a patient begins with a careful history and examination by a specialist trained in orbital diseases.

Thyroid Eye Disease

The most common inflammatory disorder that is seen in our service is thyroid eye disease, which is associated with Graves’ thyroid disease. Patients may experience bulging of the eyes, an increased opening of the eyelids, misalignment of the eyes resulting in double vision, and in rare cases, compression of the optic nerve with resulting diminished vision. The service offers a wide range treatments of thyroid eye disease including eyelid, eye muscle and/or eye-socket surgery.

Tear Ducts (Lacrimal Drainage)

The lacrimal gland is an important part of the eye. It is responsible for making tears and keeping the eye moist. A delicate balance is maintained by the lacrimal glands, which manufacture the tears, and the tear ducts, which are responsible for draining the tears from the eyes. Damage to the tear ducts can result in "dry eyes" or "wet eyes."

Dry eye occurs when the lacrimal gland fails to properly moisten the eye. This must be corrected surgically or with artificial lubricants to control the drying. Wet eyes is a condition when tears are unable to travel down the normal pathway (through the duct connecting the eyes and nose) resulting in a continuous running of tears down the face. Many different conditions can cause this, including a blocked tear duct, malfunctioning or displaced eyelids, poor quality tear composition or general dryness that causes the body's feedback loop for tear production to loose its self maintaining function. The last cause is, in fact, most common cause of lacrimal drainage problems.

Traumatic Lacerations and Fractures

Orbital trauma includes injuries to the orbit or to the tissues surrounding the eye. Examples of orbital trauma include:

• Orbital foreign body
• Orbital penetrating injuries
• Fractures and traumatic optic neuropathy
• Injury to the optic nerve.

Removal of Eyes (Enucleation)

A person is rarely born without an eye. However, eyes can be lost to trauma (such as a sport injury), infection or disease. Improvements in technology and extensive research have provided great strides with the treatment plan that is available for a patient who has lost an eye.

Advancements have occurred in:

• Surgical procedures for removing the eye (enucleation)
• Replacement of the eyeball with an implant
• Fitting of a prosthesis ("glass eye") with an ocularist to maximize each patient's appearance and function.
   

For more information about cosmetic ophthalmic procedures and the specialists who perform them, please visit the American Society of Ophthalmic Plastic and Reconstructive Surgeons, at  www.asoprs.org .