Oculoplastic Surgery

Oculoplastic Surgery

Oculoplastic surgeons are ophthalmologists (eye doctors) with additional advanced training in facial plastic surgery. The micro precision eye surgery training (use of small incisions, finer sutures and microscope) is an added advantage in performing plastic surgeries around the eyes and face .They can understand the dynamics between eyelids and eyeball better and they can perform surgeries through hidden incisions inside the eyelid avoiding skin incisions .

The eyelids and surrounding structures are complex and fragile and extremely important in maintaining vision. Eyes are noticed  first when a person looks at a face. Oculoplastic surgeons are uniquely qualified in performing complex eyelid, orbital and cosmetic surgeries around the eye and in providing eyecare simultaneously as maybe needed in the process.

When it comes to choosing a plastic surgeon for your face, it is critical to choose a specialist whose work is concentrated only in the area around the eyes and face.

List of eye disease and its treatments

This is a surgical procedure used to treat tired appearing , hooded or baggy eyelids .It involves removal of excess tissue – skin, muscle and sometimes fat, from the upper and/or lower eyelids. It improves the cosmetic appearance and increases the visual field. Also lower lid blepharoplasty may improve watery eyes. Sometimes it is done to obtain a lid crease in Asian patients.

 The result is a more youthful, rested appearance of the eyes with softening of wrinkle lines.

This surgery is performed on an outpatient basis under local anesthesia using hidden incisions. There is no scar seen in the operated eye after surgery.

Blepharoplasty can be combined with browlift, mini SMAS lift or facelift.

Botox is often combined with other cosmetic procedures such as Fillers, Blepharoplasty, Browlift, and Facelift

This is a surgical procedure to raise the level of the drooping eyebrows and forehead.       

The Brow Lift can be performed through different type of incisions either near the eyebrow (Direct brow lift), through the forehead lines, at the hair line, or through incision hidden inside the hair.

Botox is the name of one brand of botulinum toxin.It is one of the most popular non-surgical cosmetic treatment chosen by millions of men and women around the world. The treatment is proven to be effective in reducing dynamic wrinkles and facial lines to a great extent. Botox is injected into the muscle by using a very fine needle and the results can be seen within a week. It reduces the wrinkles by weakening and not paralyzing the underlying muscles which cause wrinkles. It is very effective in treating vertical frown lines, forehead lines, smile lines around the eyes (crow’s feet), lines around the mouth and facial spasms. It can be used to elevate a depressed brow .Along with fillers, it is used for facial contouring .Injections are almost painless as fine needles are used and an anaesthetic cream is applied before the procedure. They are given in the out  patient clinic.

Though these are nonsurgical procedures, it is advised to get the treatment by experts who have adequate knowledge of the facial muscles and the anatomy of the facial blood vessels; so that injections can be performed at the right sites and planes in a sterile manner; minimizing chances of infections and complications.



A filler is an injection used to restore the facial volume and youthful appearance . Commonest used is hyaluronic acid filler. This is a natural component of the joints in the body. These are available in different viscosities and molecular sizes so that we can pick and choose the exact product depending on the site and purpose of the use. The jaw line can be better defined, lips can be plumped, lower and mid face lift can be achieved as well as restoration of fullness under the eyes and in the cheeks and improvement in dark circles. These are injections given in the clinic and the effect is seen immediately. It is reversible. So if you don’t like it, an enzyme injection can dissolve the gel. Combining these fillers with botox can amazingly restore youthful appearance.

Though these are nonsurgical procedures, it is advised to get the treatment by experts who have adequate knowledge of the facial muscles and the anatomy of the facial blood vessels; so that injections can be performed at the right sites and planes in a sterile manner; minimizing chances of infections and complications.

Though these are nonsurgical procedures, it is advised to get the treatment by experts who have adequate knowledge of the facial muscles and the anatomy of the facial blood vessels; so that injections can be performed at the right sites and planes in a sterile manner; minimizing chances of infections and complications.

Ptosis is drooping of upper eyelid, making the involved eye appear smaller. Ptosis can be associated with hooded eyelid in which case the ptosis surgery can be combined with blepharoplasty. Surgery can be performed through incision on the eyelid crease or from incision inside the eyelid.

Ptosis surgery is a challenging surgery as it involves achieving symmetry not only of the eyelid height but also the eyelid contour, eyelid fold and the lid show. Hence an expert surgeon whose practice concentrates on eyelids is preferable.

Xanthelasma are yellow patches seen on the inner two-thirds of the upper and lower eyelids.  One-third of these individuals have high serum cholesterol.  In some patients, the xanthelasma are so extensive that they cover most of the eyelids and yield an unsightly appearance difficult to conceal with makeup.  Laser resurfacing and chemical peels simply do not work.  A highly skilled oculofacial surgeon can perform complete excision of these plaques followed by reconstruction of the defect.

Thyroid Eye Disease or TED is a condition wherein the eyes are affected due to abnormal thyroid hormone level in the body. Very rarely this condition can occur in the presence of normal blood thyroid levels. In TED the tissues behind the eyeball and around the eye become swollen. This makes the eye look bulgy and gives a staring appearance. Consequently, these patients hide behind glasses and have low self-esteem with some experiencing depression and social isolation.

Although risk is low, 10% people with TED can have decrease in vision or loss of vision.

Common Symptoms of TED in active phase are-

-Swelling of eyelids more in mornings and in sunlight

-Redness, discomfort and watering

-Double vision especially on prolonged reading

-Inability to completely close the eyes

-Decrease or blurring of vision noticed especially when one eye is closed.

Simple Steps to be taken at home along with medical treatment, in the active phase are-

-Head elevation while sleeping        

-Use sun glasses in sunlight

-Quit smoking

-Diabetes control

-Daily vision checks at home by closing one eye at a time so that decreased vision in one eye can be detected early.

-Look for colour desaturation at home while watching TV by closing one eye.

The staring appearance can be corrected temporarily with botox and fillers in the active phase.

Quite often there are cosmetic problems like prominence and bulging of the eyes, staring appearance, squinting , puffiness of eyelids in the inactive phase .


The treatment differs between individuals , depending upon stage of disease , symptoms and signs. Curing or stabilizing thyroid levels in the body may not stop the eye condition from aggravating. Treatment for thyroid eye disease should be undertaken simultaneously but independent of systemic disease.

Once the active stage is over, the residual bulgy eye ,squint or lid swelling will require surgical correction. These will not resolve on their own as is commonly believed. Normal appearance of the eyes can be restored by minimally invasive advanced keyhole surgeries.

Surgery is done in a staged manner. Every patient does not need all stages and sometimes two stages can be combined. The bony decompression is performed first followed by squint correction followed by eyelid and lastly, periorbital facial rejuvenation.

For bulgy eyes the bony walls around the eye are opened, so that more space is created behind the eyeball and the prominent eye returns to its normal position. This surgery is called orbital decompression. This maybe combined with removal of excessive fat behind the eyeball.

The eyelids can be corrected by blepharoplasty, lid retraction correction and sometimes ptosis correction.

This is paralysis of part of the face caused by non-functioning of the nerve that controls the muscles of the face, especially the muscles around the eye and to the mouth. Inability to close the eye can lead to exposure or drying of the cornea which can cause corneal ulcer or scarring of the cornea and permanent loss of vision.

Surgery may be advised for incomplete eye closure, and may also be required on the forehead, brow, midface, lower face or corner of the mouth to improve facial symmetry. Botox injection may be given in some cases.

One eye may be absent since birth or lost due to injury. Various treatment procedures like use of ball implants, use of lining from inside the mouth (mucous membrane grafting),dermis fat graft from buttocks,expanders etc. can be performed to restore near normal appearance. A prosthetic eye can look very natural, and movement is possible in some cases.

Artificial eyes can also be placed after removal of a painful/cosmetically unacceptable, blind eye.

Trauma is one area where expertise of a specialist is many a times required. Fractures of the bony walls of the orbit can be repaired by minimally invasive surgery with incisions from inside the eyelid and inside the mouth. The young population which is commonly involved in road traffic accidents can greatly benefit from these surgeries as surgical scars can be avoided altogether.

Late facial deformity correction is quite challenging and navigation guided/computer assisted surgery can be useful in achieving cosmetically great results. Dr Priti has pioneered this technology in India.

Many people are understandably jumping on the cosmetic bandwagon to look great for their age.  To meet the demands of their patients, physicians from various specialties are incorporating aesthetic rejuvenation treatment into their practices.  Unfortunately, without advanced knowledge of surgical anatomy or extensive training and experience, some high-level procedures may not go as planned.  Fixing these undesirable results by other surgeons (revisional surgery) is extremely challenging as it may necessitate removal of thickened scar tissue or improperly injected fat or filler; removal of excess skin left behind (dog-ear deformity); replacement of tissue lost by overzealous excision using grafts or flaps; and/or restoration of normal eyelid shape or function.  Over the past 15 years, Dr. Priti’s mastery of surgical techniques has enabled her to successfully and safely perform revisions on numerous patients and restore their quality of life.

Tumors may occur on the eyelids or in and around the eyeball. Some of them may affect vision. A variety of treatment methods are available with the goals of complete tumor removal and functional, aesthetically pleasing reconstruction.RPS hospital has all the facilities and expertise for eye cancer removal, eye tumor surgery, eye tumor treatment and orbital tumor surgery.