Reconstructive and Functional Oculoplastic

Reconstructive and Functional Oculoplastic

Functional oculoplastic and facial surgery involves repairing areas that are blocking or otherwise impairing vision. These can include:

  • Congenital defects
  • Eye/facial disorders
  • Aging
  • Burns
  • Tumors
  • Other traumatic injuries

Any of those conditions may require functional reconstructive and cosmetic surgery on and round the eye or eyelids.


Ptosis is when the upper eyelid droops over the eye. This condition is termed unilateral ptosis when it affects one eye and bilateral ptosis when it affects both eyes. The eyelid may droop just a bit, close to as much that it covers the pupil (the black dot at the middle of your eye that lets light in). Ptosis can limit or maybe completely block normal vision.

Children and adults can have ptosis. Fortunately, this condition is treated to enhance vision as well as appearance.

Who gets droopy eyelids? 

Anyone can get droopy eyelids, and there aren’t substantial differences in prevalence between men and ladies or between ethnicities.

However, it’s more common in older adults due to the natural aging process. The levator muscle is to blame for lifting the eyelid. As you age, that muscle can stretch and, as a result, cause the eyelid to fall.

Keep in mind, though, that people of all ages are often suffering from this condition. In fact, babies are sometimes born with it, though this is often rare. Sometimes the precise cause is unknown, but other times it’s going to be due to trauma. It can even be neurological.

Ptosis in children

Children born with ptosis have what’s called congenital ptosis. This could be caused by problems with the muscle that lifts the eyelid (called the levator muscle).

The most obvious sign of ptosis is a drooping eyelid. Another sign is when the upper eyelid creases don’t line up evenly with one another. A toddler with ptosis may tip their head back, lift up their chin, or raise their eyebrows to try to visualize better. Over time, these movements can cause head and neck problems.

Sometimes, a toddler born with ptosis can even produce other eye-related problems. They’ll include eye movement issues, eye muscle disease, tumors (on the eyelid or elsewhere) and other problems.

Ptosis in adults

Adults get ptosis (called involutional ptosis) when the levator muscle stretches or separates faraway from their eyelid. This could be caused by aging or an eye injury. Sometimes ptosis happens as a side effect after certain eye surgery. Rarely, diseases or tumors can affect the eyelid muscle, causing ptosis.

Serious conditions

In some cases, droopy eyelid is caused by more serious conditions, like a stroke, brain tumour , or cancer of the nerves or muscles.

Neurological disorders that affect the nerves or muscles of the eyes — like myasthenia gravis — can even result in ptosis.

What are the symptoms of droopy eyelid?

The main symptom of droopy eyelid is that one or both upper eyelids sag. In some cases, this will affect your vision. However, many find that the eyelid sagging is barely noticeable or doesn’t happen all the time.

You may even have extremely dry or watery eyes, and you’ll notice that your face looks weary or tired.

The main areas to be affected are going to be round the eyes, and you may experience aching, which may also cause you to seem tired.

Some people with severe ptosis may need to tilt their heads back so as to see at all times when speaking, even when holding a standard conversation.

The Procedure:

The treatment for droopy eyelid depends on the particular cause and therefore the severity of the ptosis. If your doctor finds that your droopy eyelid is caused by an underlying condition, you’ll likely be treated for that. This should typically stop the eyelids from sagging.

If your eyelid blocks your vision, you’ll need medical treatment. Your doctor may recommend surgery.

During this procedure, the levator muscle is tightened. This may lift the eyelid up into the specified position. For youngsters who have ptosis, doctors sometimes recommend surgery to stop the onset of lazy eye (amblyopia).

However, there are risks associated with surgery, including dry eye, a scratched cornea, and a hematoma. A hematoma is a collection of blood. Moreover, it’s not uncommon for surgeons to position the eyelid too high or too low.

Eyelid malpositions

Eyelid malposition is that the abnormal positioning of the eyelids because of various causes.

The disorder is comparatively common. As well as looking unsightly, it can result in visual and ocular problems, which may become serious.

The most common forms are:

  • Eyelid retraction: the upper eyelid is abnormally high or the lower eyelid is abnormally low.
  • Ptosis: drooping of the upper eyelid.
  • Entropion: This condition is an inversion or inward turning of the eyelid. When this happens , trichiasis can occur. This is often when the eyelashes become directed toward the eyeball. If left unchecked, corneal and conjunctiva damage can occur resulting in corneal abrasions, scarring, and thinning of the cornea. The condition can happen in either one or both eyes.
  • Ectropion: This type of malposition is the most frequent form. Highlighted by the visible process of turning inside out, the cornea and conjunctiva are exposed to the current condition. Ectropion can occur at birth or later in life.

Signs and Symptoms of Eyelid Malposition

A droopy eyelid, also called eyelid ptosis, is the most typical symptom of eyelid malpositions. This is often due to poor muscle function within the eyelid and a subsequent inability to lift it. Other signs and symptoms of eyelid malposition include:

-Impaired vision

-Pain within the eyelid

-Infections because of the eyelashes rubbing on the cornea

-Redness of the eye

Treatment of Eyelid Malposition

Eyelid malposition will be repaired with surgical procedures designed to return the eyelid to its natural position. This procedure is completed with local anaesthesia and involves tightening and repositioning the lid, while also restoring balance to the encircling muscles and tendons.

While the suitable course of action will depend upon your medical record and therefore the reason behind your ptosis, these are a number of the foremost common eyelid surgery options used for correcting eyelid malposition.

Massage and Steroid Injection: This treatment is meant to correct complications that occur because of overcorrection of the skin during a blepharoplasty. The massage and steroid injection help to correct ectropion and eyelid ptosis. The success of this treatment depends on the early identification of abnormal healing and scar tissue.

Scar Excision and Spacer: This treatment is employed when excessive scarring has occurred. The spacer provides vertical height and stiffness to assist support either the upper or lower eyelid. Before the spacer is put in, the initial scarring has got to be excised or cut away. This is often a recommended treatment for those that had a blepharoplasty that did not heal correctly or that had complications because of poor surgical techniques.

Lateral Canthal Suspension Canthopexy: Another treatment to repair complications from a blepharoplasty. This treatment would be the next step if massage and steroid injections did not fix the eyelid laxity. The main goal is to correct ectropion while promoting better vision and cosmetic appearance.

Lateral Tarsal Strip Canthoplasty: This is often used to treat many lid malpositions. The treatment corrects retraction and ectropion of the eyelid. It’s an excellent procedure to elevate and tighten the eyelid as required . Sometimes the procedure is combined with a midface lift. Proper function with improved aesthetics is the goal of this procedure.

Transconjunctival Blepharoplasty: This sort of procedure is used for surgical correction of upper and lower eyelid malposition because of aging, including upper sclera show and lid malposition.

Bell’s palsy

Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles within the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The condition causes one side of your face to droop or become stiff.

Bell’s palsy, also referred to as acute peripheral facial palsy of unknown cause, can occur at any age. The precise cause is unknown. It’s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it’d be a reaction that happens after a virus infection .

For most people, Bell’s palsy is temporary. Symptoms usually start to enhance within a couple of weeks, with complete recovery in about six months. A small number of individuals still have some Bell’s palsy symptoms forever. Rarely, Bell’s palsy can recur.


Bell’s palsy is marked by a droopy appearance on one side of the face and therefore the inability to open or close your eye on the affected side. In rare cases, Bell’s palsy may affect each side of your face.

Other signs and symptoms of Bell’s palsy include:

  • drooling
  • difficulty eating and drinking
  • an inability to create facial expressions, like smiling or frowning
  • facial weakness
  • muscle twitches within the face
  • dry eye and mouth
  • headache
  • sensitivity to sound
  • irritation of the eye on the involved side

Call your doctor immediately if you develop any of those symptoms. You must never self-diagnose Bell’s palsy. The symptoms are often almost like those of other serious conditions, like a stroke or brain tumour.

Risk factors:

Bell’s palsy occurs more often in people who:

  • Are pregnant, especially during the third trimester, or who are within the first week after birth
  • Have an upper respiratory infection, like the flu or a cold
  • Have diabetes


In most cases, Bell’s palsy symptoms improve without treatment. However, it can take several weeks or months for the muscles in your face to regain their normal strength.

The following treatments may help in your recovery.


  • corticosteroid drugs, which reduce inflammation
  • antiviral or antibacterial medication, which can be prescribed if a virulent disease or bacteria caused your Bell’s palsy
  • over-the-counter pain medications, like ibuprofen or acetaminophen, which may help relieve mild pain
  • eye drops

Home treatment

  • an eye patch (for your dry eye)
  • a warm, moist towel over your face to alleviate pain
  • facial massage
  • physical therapy exercises to stimulate your facial muscles

A squint, also called strabismus, is where the eyes point in opposing directions. It’s particularly common in young children, but can occur at any age.

One of the eyes may turn in, out, up or down while the opposite eye looks ahead. This might happen all the time or it’s going to come and go. Treatment is typically recommended to correct a squint, as it’s unlikely to get better on its own and it could cause further problems if not treated early .

Causes of squints

The exact explanation for a squint isn’t always known.

Some people are born with a squint and others develop one later in life. Sometimes they run in families.

In children, a squint is usually caused by the eye attempting to beat a vision problem, such as:

  • short-sightedness – difficulty seeing things that are distant
  • long-sightedness – difficulty seeing nearby objects
  • astigmatism – where the front of the eye is unevenly curved, causing blurred vision

Rarer causes of a squint include:

  • some infections, like measles
  • some genetic conditions or syndromes, like down’s syndrome
  • developmental delays
  • cerebral palsy
  • other problems with the brain or nerves

A squint can even sometimes be an indication of a rare sort of childhood eye cancer called retinoblastoma. Take your child to examine a GP if they have a squint to rule out this condition.

Treatments and surgery for a squint

The main treatments for a squint are:

  • Glasses – these can help if a squint is caused by a problem with your child’s eyesight, like long-sightedness.
  • Eye exercises – exercises for the muscles that control eye movement may sometimes help the eyes work together better.
  • Surgery – this involves moving the muscles that control eye movement therefore the eyes line up correctly. it’s going to be recommended if glasses aren’t fully effective on their own. Read more about squint surgery.
  • Injections into the eye muscles – these weaken the eye muscles, which may help the eyes line up better. But the effect usually lasts less than 3 months.

If your child contains a lazy eye as a result of their squint it should need to be treated first.

Treatment for a lazy eye usually involves wearing a patch over the unaffected eye to assist improve vision within the affected eye.

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