What are the common oculoplastic conditions?
Trichiasis - Inwardly directed eyelashes. Should try to remove permanently by applying low voltage current to the roots of the lashes (Electropilation).
Entropion - Inward turning of eyelid margins towards the eyeball.
Ectropion - Outward turning of eyelid margins.In both the conditions patient may suffer from redness, watering, discharge, foreign body sensation, etc. Entropion may cause vision damaging corneal ulcers also due to rubbing of the eyelashes.
Ptosis - Drooping of the upper eyelid, one or both. It might be present since birth, and can lead to vision deficit due to light obstruction, causing “lazy eye” (Amblyopia). It requires prompt intervention. Adult ptosis might need correction for cosmetic betterment, or removing sight obstruction.
Eyelid tumors – Like tumours of any body parts these may be benign, malignant or inflammatory (styes). Inflammations are treated medically. Tumours need surgical removal with reconstruction. Biopsy to confirm nature of tumour. Eyelids are essential for healthy functioning of the eyes. So gaps in the lids have to be reconstructed immediately.
Orbital tumours - Tumours between the eyeballs and the bony orbits. They can push the eyeball to abnormal positions. They can damage vision by pressing on the eye nerve. Surgical removal of these tumours require very special skills.
Evisceration and Enucleation - Surgeries to remove non-functioning eyeballs, which may be painful, disfigured following trauma, or having tumours inside them.
Anophthalmic socket - Socket without eyeball. May be a defect since birth, or created after surgical removal of eyeballs. Cosmetic surgery to improve the looks of the patient is often psychologically very important.
Lacrimal passage obstruction - Tear drainage passage from eye to nose is blocked. Can be present since birth. Needs intervention within 1- 2 years of age before the surrounding bones become hard. In adult cases, most common surgery (DCR) creates an artificial passage through the bone into the nose. In few extreme cases the infective sac is removed.
IS IT ONLY A COSMETIC CORRECTION?
The improvement in self-image and self-esteem is one of the major benefits of strabismus surgery. Many a times there may be improvement of binocular vision and increase in visual field of the adult patient.
IS THE SURGERY SUCCESSFUL?
In most of the cases a perfect alignment is achieved. Occasionally a partial alignment is achieved which might require an additional surgery. Sometimes a misalignment may develop after a few years which can be corrected by additional surgeries as well.
IS THERE ANY SIDE EFFECT TO SURGERY?
Adults may complain of temporary diplopia which resolves by a couple of weeks. A red eye, occasional watering and discomfort may persist for a few weeks. Vision threatening side effects are rare.
CAN STRABISMUS LEAD TO LOW VISION ?
When the eyes are not perfectly aligned the deviated eye has a chance of developing poor vision.The brain tends to ignore the image of the deviated eye to avoid diplopia and this results in poor visual development.This is often referred to as Strabismic Amblyopia.
CAN ADULT STRABISMUS BE CORRECTED?
Adult strabismus can be corrected following the same method as pediatric strabismus. The misalignment may improve with glasses, with or without surgery.
DOES THE CHILD REQUIRE AFTERCARE?
Following cataract surgery, the child is given glasses and recommended patching to ensure complete visual development. If the steps are not carried out properly, it may result in Visual Deprivation Amblyopia (Low Vision).
HOW EARLY SHOULD THE CHILD UNDERGO SURGERY?
The child may undergo surgery as early as 3 months of age.
WHAT IS THE TREATMENT?
If the cataract causes an obstruction in the passage of light it needs to be removed. Cataract surgery should be done as early as possible if it affects children.
WHAT IS CATARACT?
Cataract is any opacity or cloudiness of the natural lens which is usually clear.