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Oculoplastic procedures

Eye surgery - oculoplastic

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Description

An oculoplastic procedure is a type of surgery done around the eyes. You may have this procedure to correct a medical problem or for cosmetic reasons.

Oculoplastic procedures are usually done by eye doctors (ophthalmologists) who have special training in plastic or reconstructive surgery. In some cases, procedures are performed by doctors who specialize in head and neck surgery.

Conditions Treated

Oculoplastic procedures may be done on the:

• Eyelids
• Eye sockets
• Eyebrows
• Cheeks
• Tear ducts
• Face or forehead

These procedures treat many conditions. These include:

• Droopy upper eyelids (ptosis)
• Eyelids that turn inward (entropion) or outward (ectropion)
• Eye problems caused by thyroid disease, such as Graves' disease
• Skin cancers or other growths in or around the eyes
• Weakness around the eyes or eyelids caused by Bell palsy
• Tear duct problems
• Injuries to the eye or eye area
• Birth defects of the eyes or orbit (the bone around the eyeball)
• Cosmetic problems, such as excess upper lid skin (dermatochalasis), bulging lower lids, and "fallen" eyebrows

Before Your Surgery

Your surgeon may give you some instructions to follow before your surgery. You may need to:

• Stop any medicines that thin your blood. Your surgeon will give you a list of these medicines.
• See your regular health care provider to make sure it is safe for you to have surgery.
• To aid with healing, stop smoking and using tobacco 2 to 3 weeks before and after surgery.
• Arrange to have someone drive you home after surgery.

What to Expect

For most procedures, you will be able to go home the same day you have surgery. Your procedure may take place in a hospital, an outpatient facility, or the provider's office.

Depending on your surgery, you may have local anesthesia or general anesthesia. Local anesthesia numbs the surgical area so you do not feel any pain. General anesthesia puts you to sleep during surgery.

During the procedure, your surgeon may place special opaque contact lenses on your eyes. These lenses help protect your eyes and shield them from the bright lights of the surgical room and any lasers that your surgeon may use.

Self-care at Home

Your recovery will depend on your condition and the type of surgery you have. Your provider will give you specific instructions to follow. Here are some tips to keep in mind:

• You may have some pain, bruising, or swelling after surgery. Place cold packs over the area to reduce swelling and bruising. To protect your eyes and skin, wrap the cold pack in a towel before applying it.
• You may need to avoid activities that raise your blood pressure for about 3 weeks. This includes things such as exercise and lifting heavy objects. Your provider will tell you when it is safe to begin these activities again.
• Do not drink alcohol for at least 1 week after surgery. You may also need to temporarily stop taking certain medicines.
• You will need to be careful when bathing for at least a week after surgery. Your provider can give you instructions for bathing and cleaning the area around the incision.
• Prop your head up with a few pillows to sleep for about 1 week after surgery. This will help prevent swelling.
• You should see your provider for a follow-up visit within 7 days after your surgery. If you had stitches, you may have them removed at this visit.
• Most people are able to return to work and social activities about 2 weeks after surgery. The amount of time can vary, depending on the type of surgery you had. Your provider will give you specific instructions.
• You may notice increased tears, feeling more sensitive to light and wind, and blurring or double vision for the first few weeks.

When to Call the Doctor

Contact your provider right away if you have:

• Pain that does not go away after taking pain relievers
• Signs of infection (an increase in swelling and redness, fluid draining from your eye or incision)
• An incision that is not healing or is separating
• Vision that gets worse

References

Boyd K, DeAngelis KD. Eyelid surgery. American Academy of Ophthalmology. www.aao.org/eye-health/treatments/eyelid-surgery. Updated April 25, 2022. Accessed February 7, 2023.

Burkat CN, Kersten RC. Malposition of the eyelids. In: Mannis MJ, Holland EJ, eds. Cornea. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 26.

Nassif PS, Kerolus JL. The aesthetic brow and forehead. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Nerad JA. Clinical anatomy. In: Nerad JA, ed. Techniques in Ophthalmic Plastic Surgery. 2nd ed. Philadelphia, PA: Elsevier; 2021:chap 2.

Venkateswaran N, Nikpoor N, Perez VL. Surgical ocular surface reconstruction. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 4.33.

Review Date: 11/10/2022  

Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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