Introduction The emotional distress which frequently accompanies the removal of an eye is reduced considerably by a cosmetic final result. The appearance of the prosthesis will be enhanced and its mobility will be improved if a buried orbital implant is…
Introduction Corneal exposure is the most serious sequel to eyelid retraction. It may also occur with the eyelids in a normal position if there is poor closure, especially in the presence of reduced tear production, a poor Bell's phenomenon or…
Introduction A predictable sequence of changes occurs in the face as we age. Early changes are barely discernible and few seek a surgeon's help. Later, more obvious changes lead to a wide variety of cosmetic and functional surgical interventions. The…
Introduction More than any other oculoplastic surgery ptosis surgery depends on a thorough understanding of eyelid anatomy. Particular care must be taken in the assessment because not all ptosis should be corrected surgically. Classification Myogenic: Isolated congenital ptosis (congenital levator…
Introduction Although ingrowing lashes are usually only a minor irritant they may cause permanent scarring of the cornea and threaten sight, especially if the cornea is insensitive or the eye is dry. Classification: Trichiasis Distichiasis Trichiasis is a common, acquired,…
Introduction Neglected ectropion leads to epiphora and secondary cicatricial changes in the skin. A vicious circle is set up which is increasingly difficult to reverse the longer surgery is delayed. Classification Involutional Cicatricial – generalised – linear Paralytic Mechanical Exclude…
Introduction Entropion of the upper or lower eyelids causes pain and leads eventually to corneal scarring. The changes occur more rapidly if there is also a poor tear film. Classification: Involutional Cicatricial Congenital Although less common than involutional entropion, cicatricial…
Introduction In this chapter a basic set of instruments for ophthalmic plastic surgery is suggested. Extra instruments for particular procedures may be added. 5.1 The basic instruments The basic instruments Top row, left to right: Castroviejo needle holders Barraquer needle…
Introduction Local anaesthesia is very satisfactory for most ophthalmic plastic procedures. Children and some adults require general anaesthesia. Extensive procedures are more conveniently done under general anaesthesia because of the volume of local anaesthetic that would be required. Premedication A…
Introduction In this chapter many of the techniques of examination used in ophthalmic plastic surgery are described. After taking an accurate history it is helpful to approach the examination in a methodical way. The relative importance of each test varies…