Oculoplasty

1–10 of 15 articles Page 1 of 2
All Cornea 36 Cataract 17 Glaucoma 14 Retina & Vitreous 72 Neurophthalmology 8 Oculoplasty 15 Uvea & Inflammatory Diseases 24 Miscellaneous 20 Oncology 9 Pediatric Ophthalmology 16
  1. 15 min read

    Dacryocystorhinostomy (DCR) : Tips & Tricks for Postgraduates

    Dacryocystorhinostomy (DCR), a century-old procedure described by Toti in the early 1900s, remains the gold standard for treating Nasolacrimal Duct Obstruction (NLDO).1 For any other procedure related to the treatment of NLDO, they are all compared and evaluated against DCR. The surgical anatomy overlaps the areas of expertise of an ophthalmologist or an oculoplastic specialist and an otolaryngologist, as the majority of the Nasolacrimal duct lies in the nasal cavity. Therefore, both external and endonasal approaches are available. In 1893, Caldwell first described the endonasal approach of DCR,2 and almost a decade later, in 1904, Toti described the external approach of DCR, which became the gold standard for the treatment of NLDO. The main goal of DCR is to create a fistulous tract lined with epithelium from the lacrimal sac into the nasal cavity. Although the endonasal approach was first described, it did not gain popularity due to the non-availability of nasal endoscopes and diffic

    Dr. Saurabh Kamal
  2. 9 min read

    Ten Pearls to Improve Your Surgical Skills in Oculoplasty

    Oculoplastic surgery, despite being a niche surgical branch, encompasses a variety of procedures involving the nasolacrimal apparatus, orbit and eyelids. Having evolved into a speciality only in the last 6-7 decades, it also includes fields such as trauma, oncology and oculofacial aesthetics, which make it fascinating as well as challenging1. Just as in most ophthalmic sub-specialities, Oculoplastics has a steep learning curve for most of the surgical interventions and each case is vastly different from the next. Here are our Ten Pearls that should help the beginner Oculoplastics consultant, fellow or fellowship aspirant to hone their skills in a more systematic manner: 1. Documentation and history taking: One of the most essential skills in an oculoplastic practice is uniform and accurate pre- and post-operative documentation. It is important from a legal as well as an academic standpoint, to take patient photographs as well as measurements of the specimen that have been obtained intr

    Dr. Ashok Grover · Dr. Rwituja Thomas
  3. 9 min read

    Ptosis Surgeries: Made Simple for The Postgraduates

    Ptosis refers to a vertical narrowing of the palpebral fissure secondary to drooping of the upper eyelid to a lower than normal position. Multiple surgical procedures can be used to correct ptosis including, frontalis sling, levator advancement, Fasanella Servat operation, and Mullerectomy. The selection of one technique over another depends on the consideration of several factors including the degree of ptosis, the degree of levator muscle function as well as the surgeon experience. Detailed examination and accurate measurements help to decide the procedure that may be required in each patient. When to treat The primary indications for treatment of congenital ptosis are amblyopia and abnormal head positioning. In the setting of severe unilateral ptosis, stimulus deprivation amblyopia is imminent and early surgery is advised and routinely performed at preschool age. Severe bilateral (or unilateral) ptosis can cause a patient to assume an obvious chin-up head position that can interfere

    Dr. Namrata Adulkar
  4. 12 min read

    i-File: Thyroid Eye Disease

    Case presentation: A 65-year-old man presented to our clinic with gradually progressive protrusion and swelling of both eyes and double vision for 1 year associated with progressive drooping of the right upper eyelid. There is acute onset of pain in the left eye for 10 days. A smoker for 25 years. Past ocular history No h/o previous ocular surgery or trauma Past medical history The patient is a diagnosed case of hyperthyroidism, Graves’ disease for 2 years. On treatment with Tablet Neomercazole 5mg per day. No history of radio-iodine therapy. The patient has no history of diabetes, hypertension, or cardiac disease. Family history No significant history Ocular Examination: Right Eye Left Eye IOP 18 mmHg 21 mmHg VISUAL ACUITY (UCVA) 6/60 3/60 BCVA 6/24 6/60 COLOUR VISION NORMAL 8/21 OCULAR MOTILITY -1 RESTRICTION IN ALL DIRECTIONS -3 RESTRICTION IN ELEVATION -2 RESTRICTION IN ALL DIRECTION PALPATION NO PALPABLE MASS NO PALPABLE MASS LIDS AND LASHES NEAR-COMPLETE PTOSIS NO LAGOPHTHALMOS L

    Dr. Rwituja Thomas · FNN · +1 other
  5. 5 min read

    Pearls in the Diagnosis and Management of Rhino-Orbito-Cerebral-Mucormycosis

    “The more you know about the past, the better you are prepared for the future.” – Theodore Roosevelt 1. Elicit adequate history Considering the lethal and angio-invasive nature of Rhino-Orbital-Cerebral-Mucormycosis (ROCM) supplemented in this COVID-19 era, it is mandatory to understand the causative factors of the disease. Diabetes mellitus, oral and systemic corticosteroids, immunosuppressive drugs like tocilizumab, remdesivir, hospital admission, supplemental oxygen, mechanical ventilation, primary or secondary immunodeficiency, hematological malignancies, stem cell transplantation, solid organ malignancies and solid organ transplantation, iron overload etc have been considered the important predisposing factors. The history acts like the guiding lantern onto the path towards appropriate management. “Ignoring the signs is a good way to end up in the wrong destination” 2. Identify the Red Flag signs In-depth knowledge about the red flag signs enables the clinicians to recognize the w

    Dr. Rolika Bansal · Dr. Santosh G Honavar, MD, FACS
  6. 16 min read

    Facial Spasms: Diagnosis and Management

    Introduction Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both [1]. They may be isolated or combined with other neurological symptoms or movement disorders [1]. Dystonia is classified based on the age of onset, etiology, clinical features, and body distribution. The body distribution may be either focal, segmental, multifocal, generalized, or hemi-dystonia. Only one region of the body is affected by focal dystonia. It emerges in late adulthood [1]. Patients with movement disorders isolated to the facial region often visit an Ophthalmologist. A brief knowledge about the identification and differentiation of the various facial movement disorders is essential. The disorder can be functionally or socially distressing to the patients. The facial movement disorders include orbicularis myokymia, Benign Essential Blepharospasm (BEB), Apraxia of Lid Opening (ALO), Hemifacial

    Dr. Varshitha Hemanth Vasanthapuram · Dr. Milind N Naik
  7. 11 min read

    DCR: When You Start,Do It Right !!

    Introduction: Dacryocystorhinostomy (DCR) is a procedure wherein an alternate passage is created between the lacrimal sac and nasal mucosa through a bony ostium, bypassing the normal lacrimal pathway. Indications: 1. Persistent congenital lacrimal duct obstruction unresponsive to conservative management. 2. Primary acquired nasolacrimal duct obstruction (PANDO). 3. Secondary acquired nasolacrimal duct obstruction (SALDO). Types: DCR can be classified as either external or internal. In external DCR the bone of lacrimal sac fossa is accessed through a cutaneous incision over the medial canthus. In internal DCR the normal openings around the lacrimal outflow system ( puncta, canaliculus, nasal cavity) are utilized to create the passage between the lacrimal sac and nasal cavity, without any skin incision. Internal DCR is most commonly performed through an endonasal approach and can be performed by using roungers, drills and even lasers. Endonasal DCR s can be performed either under endosco

    Dr. Md. Shahid Alam · Dr. Bipasha Mukherjee
  8. 21 min read

    The Lacrimal Apparatus

    Development of the lacrimal secretory apparatus: The lacrimal gland develops from solid ectodermal buds in the anterior superolateral part of the orbit. The gland does not start functioning fully until approximately 6 weeks after birth. Newborn infants do not produce tears while crying. Development of the lacrimal excretory system: The Nasolacrimal duct opens in the inferior meatus of the nose. Failure of the caudal end to canalize at birth results in congenital nasolacrimal duct obstruction, which resolves spontaneously in the majority of cases within 4-6 weeks of birth. Anatomy of the lacrimal system: The lacrimal secretory apparatus Tears are secreted by the main and accessory lacrimal glands. The main lacrimal gland is located in the lacrimal gland fossa in the superotemporal quadrant of the orbit. The lacrimal gland has two lobes, the larger almond-shaped orbital, and the smaller palpebral lobe. These lobes are divided by the lateral horn of the levator aponeurosis. The palpebral

    Dr. Jayant Kadaskar · Dr. Md. Shahid Alam · +1 other
  9. 21 min read

    Long Case of Ptosis

    Blepharoptosis refers to the inferodisplacement or drooping of the upper eyelids.The condition can be congenital associated with the presence of a dystrophic levator muscle or acquired due to a myogenic, neurogenic, mechanical, aponeurotic or traumatic cause. We aim to provide certain general guidelines to the management of a patient with ptosis. In assessment of long case of ptosis the clinical examination should start with History as with any other case. History: Obtain a thorough medical and ophthalmic history. The onset of ptosis, Alleviating or aggravating factors, Family history of ptosis Whether increasing, decreasing, or constant since the time of manifestation Association with Jaw movements Abnormal ocular movements Abnormal head posture History of Trauma or previous surgery Poisoning Use of steroid drops Any reaction with anesthesia Bleeding tendency Previous photographs may prove to be of great help. Ocular Examination: Head Posture: A significant head posture (usually chin

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other
  10. 14 min read

    Eyelid Trauma

    In recent times, eyelid injuries are on the rise primarily because of the increasing incidence of road traffic accidents, industrial mishaps and intentional assaults on the human body. Injury to the eyelids, lacrimal system or orbital wall may be isolated or may occur in association with mid facial injuries. History A precise history is essential to assess the severity of the injury. In some cases, an ophthalmologist can anticipate the extent and severity of injury from the mechanism of injury. It is important to elicit the mode of injury, whether it is with sharp or blunt objects or due to thermal or chemical injury or due to dog bites. In cases of animal bites, a complete tetanus immunization history is obtained and if required proper immunization should be given. Examination Of The Patient The patient’s injury must be dealt with according to the priority. The basic “ABC’s” (Airway, Breathing, Circulation) must be evaluated, before proceeding to the management of localized injury. Th

    Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other