ORBIT FRACTURES

Orbital fractures are a common midfacial trauma. Orbital fractures account for 40 % of all fractures of the facial skeleton. Isolated orbital fractures are observed in ~35–40 % of cases, while 30–33 % of injured patients have two walls damaged. In children, orbital fractures account for 23 % of all facial traumas. Trapdoor- type fractures constitute 25–70 % of all orbital fractures in the pediatric population. 70 % of all orbital fractures are combined with certain injuries of the globe, other facial bones, and head trauma.

The orbital fracture can cause functional impairment and cosmetic disfigurement as well. A timely repair will give very good results. Oculoplasty surgeons know the periocular functional anatomy very well and so can deal with orbital fractures alone or in association with plastic or maxillofacial surgeons. The transconjunctival route is the most aesthetic approach to repair the orbital floor and medial wall fractures.

THYROID ASSOCIATED OPHTHALMOPATHY

Thyroid-Associated Ophthalmopathy is associated with dysthyroid or euthyroid status. It is an autoimmune disease. It is also known as Grave's Orbitopathy or Thyroid Eye Disease or Thyroid Related Orbitopathy. The clinical presentation varies from mild to most severe, sight-threatening, disease. It can cause functional deficits, cosmetic disfigurement and compromised quality of life. A timely interventional approach by an oculoplastic and an endocrinologist can make a huge difference in the final outcome of the disease.

COSMETIC ARTIFICIAL EYE

Loss of vision indeed causes profound mental trauma. If the vision loss is accompanied by disfigurement of the eye it further adds to the trauma and decreases patient's self-confidence. The disfigurement can be very well corrected by an appropriate surgery as advised by an oculoplastic surgeon and a custom-made ocular prosthesis. The results are very satisfying in a typical case.

WATERY EYE IN CHILDREN

Watery eye in children is commonly due to a membranous obstruction at the opening of the nasolacrimal duct in the nose. This is known as congenital nasolacrimal duct obstruction. The management is usually conservative with massage (after every feed) and antibiotic eye drops if there is an infection. Surgical intervention can be postponed till the age of 10- 12 months.  It does not harm a child’s eyesight ever. Surgery is a very minor procedure under general anesthesia & takes 20 to 25 minutes without any scar. It must be done under endonasal endoscopic guidance to get the best results.  An oculoplastic surgeon is trained for the procedure.

EYELID PTOSIS

Drooping of the upper eyelid is known as ptosis. There are many causes of ptosis. As eyelid is very very important to our eyes, functionally and aesthetically, ptosis requires specialist care - known as Oculoplasty Surgeon. Once the surgeon evaluates and decides for surgery, the surgery can be done with an incision in the eyelid crease which will be hidden and so with very satisfactory cosmetic result. The surgery takes approximately 45 minutes and postoperative recovery requires 7 days typically. Occasionally finer adjustment may have to be done after 7 days postoperatively.

EYELID PTOSIS I

EYELID PTOSIS PART II