Oculoplastics

Oculoplastics refers to surgical procedures relating to the eye socket, eyelid and tear ducts, which treat conditions such as droopy eyelids, tumours and blocked tear ducts. A number of treatments are available depending on the condition.

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About Watery eyes and blocked tear ducts

Tears are produced continuously and are drawn into a small hole in the inner corner of each of the upper and lower eyelid known as a punctum. They lead into small tubes known as the canaliculi, which in turn drain into the lacrimal or tear sac. This lies between the corner of your eye and your nose and has a duct at the bottom (the nasolacrimal duct), which drains into your nose.

Most cases of lacrimal obstruction occur for unknown reasons. However, a few identified causes are:

  • Congenital malformation of the lacrimal drainage system, i.e. a small number of children are born with blocked tear ducts
  • Severe forms of conjunctivitis
  • Some chemotherapy agents and eye drops
  • Surgical or traumatic damage to the drainage system

Symptoms

If the nasolacrimal duct is blocked the eye becomes watery, and sometimes sticky.  Some people develop a painless swelling of the lacrimal sac at the inner corner of the eye and in a few people this swelling becomes infected, causing a red, tender lump or abscess.

Diagnosis

Your ophthalmologist will perform some tests which might include syringing water through the tear ducts to see whether there is a blockage. Sometimes, various scans of the tear drainage pathway (eg. dacryocystogram, dacryoscintillogram, MRI) are needed to help assess watery eyes and plan treatments.

Treatments

Most cases of confirmed obstruction will require an operation to relieve symptoms once they occur. The primary aim of treatment is to either unblock the system, or to bypass any obstruction. Some causes of lacrimal obstruction can be treated with putting silicon tubing into the lacrimal system.

About Eyelid Surgery

Eyelid surgery is usually performed under local anaesthesia with or without sedation.

The aims of eyelid surgery are:

  1. To correct eyelid malpositions that can occur from ageing or disease processes. Eg. ectropion (eyelid turning out), entropion (eyelid turning in).
  2. To improve hooded, droopy or baggy eyelids. Eg. ptosis, brow ptosis, dermatochalasis (“baggy eyes”).
  3. To remove eyelid cysts, scars and tumours. Eg. chalazion / styes, papillomas, tarsal cysts, BCC (basal cell carcinoma), SCC (squamous cell carcinoma), SGC (sebaceous gland carcinoma).
  4. To reconstruct eyelid defects following eyelid trauma or tumour removal.
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