What is occuloplastic surgery?
Occuloplastic surgery deals with the management of deformities and abnormalities of the eyelids, the lacrimal (tear) system and the orbit (the bony cavity surrounding the eye).

The eyelid
The eyelids are complex structures that protect the eye and spread tears across the surface of the eye. The position and contours of the eyelids are important features of the facial appearance. Abnormalities in the eyelids’ position, function and appearance can result from many causes, including birth defects, aging, tumors, injury or medical diseases such as thyroid disorders. Eyelid operations may be either reconstructive to restore function, or cosmetic to improve appearance.

Types of eyelid surgery

• Ptosis – Correction of upper eyelid drooping, apparent at birth or develops with age
• Blepharoplasty – Correction of baggy eyelids
• Ectropion – Correction of outward turning of the lower eyelid
• Entropion – Correction of inward turning of the lower eyelid
• Reconstructive Eyelid Surgery – After eyelid trauma, removal of eyelid cancers, or for conditions that cause retraction (tight) eyelids.

Lacrimal System (Tear Ducts)
The lacrimal gland is located under the outer one-third of the upper eyelid. Its function is to make tears that spread over the surface of the eye. When you blink, the eyelid spreads the tears over the surface of the eye and pumps excess tears into a pipe in the corner of the eyelid that drains tears into the nose.

If the gland fails to produce enough tears to keep the eye moist, dry eyes result. An eye that is too dry typically burns, stings and feels as though there is sand in it. If lubricants do not relieve discomfort, surgically closing the pipe that drains the tears from the eyes into the nose may help by allowing the tears to stay on the eye longer.

If the gland produces tears properly, but the pipe that drains the tears is not functioning, the tears will back up and spill over the eyelid. Stagnant tears within the system can become infected. An infection within the tear pipe causes a painful swelling in the inner corner of the eyelids. Surgical elimination of the obstruction is necessary to eliminate the tearing and infection.

Children are frequently born with an obstruction within the tear pipe. These stagnant tears often become
infected, causing pus to collect between the eyelids. If the condition does not improve over a short time,
ophthalmologists use surgical techniques to remove the blockage.

The orbit
The orbit is the bony socket that surrounds the eye. Anything that causes swelling and enlargement of the orbital structures behind the eye will push the eye forward and may restrict its movement. Double vision results if an eye moves improperly.

Types of conditions

• Thyroid Eye Disease – The thyroid gland, located in the neck, produces thyroid hormone that helps regulate the body’s metabolism. It may produce either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism). Hyperthyroidism is associated with Graves disease, which can cause eye and vision problems. Treatment involves reducing discomfort, avoiding double vision and preserving sight. Surgical and non-surgical options exist to treat these conditions.
• Orbital Tumors – Tumors may affect the structures within the orbit. As they enlarge, the eye bulges forward and its movement may be limited. Management of these tumors requires sophisticated diagnosis and surgical intervention.
• Orbital Injuries and Fractures – Trauma to the orbit may cause fractures of the bone surrounding the eye. Fractures may result in deformities of the face and poor movement of the eye and may cause the eye to sink into the orbit. Precise evaluation and repair oforbital fractures is vital for protection and function of the eye.

Occuloplastic Diseases and Types of Treatments available at the Krieger Eye Institute at Sinai Hospital of Baltimore

Occuloplastic Procedures Performed at the Krieger Eye Institute:

Krieger Eye Institute
The Krieger Eye Institute offers the Baltimore area a convenient community location with a nationally-recognized team of board-certified physicians. Using the most advanced technology, combined with compassionate care, the entire staff of Krieger Eye Institute is here to help you realize the best vision possible.

For an appointment
The Krieger Eye Institute is located in the Morton Mower, M.D., Medical Office Building at Sinai Hospital. To make an appointment, please call 410-601-8143.