Oculoplasty for general ophthalmologists

Abstract

Many oculoplastic conditions like ectropion, entropion, ptosis, lid lacerations, canalicular trauma and dacryocystitis are commonly seen in everyday practice of any ophthalmologist. Delay in treatment of entropion and ectropion can lead to blindness due to development of secondary changes in cornea. Neglecting a child with severe ptosis can result in irreversible visual loss. Incorrect primary repair of lacerated lid and failure to repair the torn canaliculi are difficult to handle at a later stage even by an expert surgeon. Long-standing blocked distal lacrimal passages may result in suppurative infections with skin excoriation. This review elucidates the correct approach to some common oculoplastic diseases so as to achieve a timely intervention and referral and thereby avoid preventable complications.

Keywords:

• canalicular injury
• dacryocystorhinostomy
• ectropion
• entropion
• epiphora
• general ophthalmologist
• lid repair
• ptosis

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• A thorough and in-depth knowledge of orbital and adnexal anatomy goes a long way in guiding surgical management.

• Multiple factors play a key role in pathophysiology of entropion and ectropion, each of which needs individualized approach.

• Every surgical procedure in ptosis has specific indications and final decision on where to use a particular surgery cannot be guided solely by a single factor, hence repeated preoperative examinations are a must in a ptosis patient.

• Restoration of complete eyelid margin anatomy while repairing eyelid margin defects provides good functional as well as cosmetic outcome.

• External dacryocytorhinostomy is an excellent and safe surgical procedure for general ophthalmologists to treat primary nasolacrimal duct obstruction.