What is Oculoplastics?

Oculoplastics is a subspeciality of ophthalmology that is the medical and surgical management of conditions affecting the periorbital and facial tissues. Oculoplastics can be broken down into its derivates: Oculo- pertains to the eye and plastos is Greek for “formed or molded”. As a whole, the term Oculoplastics defines plastic surgery around the eye and surrounding areas. Plastic surgery can be either reconstructive or cosmetic.

Oculoplastic surgeons are ophthalmologists who have gone through years of additional fellowship training to specialize in reconstructive surgery of the eyelids, orbits, and lacrimal system.

Oculoplastic surgeons diagnose and treat various conditions, including:

  • Ptosis – a condition characterized by droopy upper eyelids.
  • Dermatochalasis–  excess skin of the upper eyelids.  This can be visually obstructive if severe or may be cosmetic.
  • Ectropion – the lower eyelid rolls outward and droops away from the eye.
  • Entropion – the inward turning of the upper or lower eyelid, causing eyelashes to rub against the eyeball.
  • Eyelid lesions – bumps, or growths that occur close to the eyes and can either be benign or cancerous.
  • Brow ptosis – the lowering of the eyebrow from its normal anatomical position to a point where there are vision field deficiencies due to extra tissue pushing down on the eyelid.
  • Obstructed tear ducts – blockage of the tear ducts either from birth, injury, or illness that is primarily characterized by excessive tearing.

View our full gallery of before and after photos! All photos are of our patients who have had surgery with Dr. Kristen Dunbar.

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Ptosis is the drooping of one or both of the upper eyelids. It is related to the decreased function of the eyelid muscles. You can be born with this condition or it may be caused by aging, trauma, or an underlying muscular or neurological disease. This condition may affect one’s vision by blocking the superior visual field. Ptosis can be treated by surgical repair to improve the field of vision and establish symmetry between the eyelids. Ptosis repair surgery is an outpatient procedure that can be performed at an ambulatory surgical center or in the office.

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As you age, the skin and muscles of your eyelids may sag and droop. You may get a lump in the eyelid due to normal fat around your eye that begins to sag forward. This condition is treated with a procedure called ‘blepharoplasty’. These changes can lead to other problems. For example:

  • Excess skin on your upper eyelid can block your peripheral vision (what you see to the sides when you look straight ahead). Your forehead might get tired from trying to keep your eyelids open. The skin on your upper eyelid may get irritated.
  • Loose skin and fat in the lower lid can create “bags” under the eyes that are accentuated by drooping of your cheeks with age. Many people think these bags look unattractive and make them seem older or chronically tired.

Upper or Lower Blepharoplasty (eyelid surgery) can help correct these problems. Patients often refer to this surgery as an “eyelid tuck” or “eyelid lift.” Please know that the eyelid itself may not be lifted during this type of surgery, but instead the heaviness of the upper eyelids and/or puffiness of the lower eyelids is usually improved.

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Ectropion (Turned-Out Eyelid)

Ectropion is the outward turning of the eyelid, most commonly affecting the lower lids. This lid sagging can lead to excessive ocular dryness, tearing, and irritation. Ectropion is often caused by aging, trauma, and facial nerve paralysis. Ectropion can be temporarily treated with artificial tears and ointments, but the permanent solution is outpatient surgery to correct lid direction.
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Entropion  (Turned-In Eyelid)

Entropion is a condition where the upper or lower eyelid turns inward, rubbing the lashes against the eye, causing the eye to become irritated, red, and sensitive to light and wind. If it is not treated, the condition can lead to pain, tearing, discharge, and irritation. If entropion is severe or left untreated for a long period of time, it can lead to corneal damage and decreased vision. If entropion exists, it is important to have a doctor surgically repair the condition before permanent damage occurs to the eye.
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Nasolacrimal Duct Obstruction (NLDO)

NLDO is when the eye’s natural drainage system becomes clogged. It usually presents with mucus buildup, and excessive tearing. After the identification of the blockage, a physician may begin by recommending warm compresses and antibiotic eye drops. If these do not alleviate the symptoms, surgical intervention via dacrocystorhinostomy (DCR) may be the method used to correct this obstruction.
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The Doctors at Eye Specialists & Surgeons of Northern Virginia have either authored or reviewed and approved this content.

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