Hering’s Law for the eyelids: There is reflexive descent of the contralateral upper eyelid after the ipsilateral surgical correction of unilateral ptosis. Hering’s law is explained by considering the two eyes as paired organs and it follows that the muscles moving it will work in co-ordination.
Droopy Eyelid Surgery or Ptosis correction surgery is more art than science. I’m sure all Oculoplastic Surgeons agree it is a challenge to treat patients with ptosis. Each case is so different that it is almost feels like you are starting from scratch. While challenging, it is also among the most satisfying Oculoplastic conditions to treat.
Facial Trauma can be damaging with tissue loss. Despite accurate and meticulous reconstruction, the scarring can be severe in the face. Scar modulation is an essential part of post trauma care and I often advise patients as much when they come with traumatic injuries of the face.
After ruling out any connective tissue disorder which could also cause such a condition, I performed the Lateral Canthoplasty (Reconstructing the lateral canthus) thus restoring the ideal almond shape of the palpebral (eyelid) opening. Not just a new lateral canthus needs to be reconstructed, we also have the make sure the eyelid do not stick back together by using silicone bolsters as tissue spacers.
It is very rare that oculoplastic surgeons are asked to provide access to interventional neuro-radiologists. This is one such case. We have performed such interventions in 3 cases till date at our hospital with similarly successful outcomes. The important thing to remember as a surgeon while accessing the SOV is that the vein is arterialised due to the CCF and bleeding can be very severe is the vessel wall is damaged.
Epidermal Inclusion Cyst (also known as Epidermoid cyst or Sebaceous cyst) is a benign encapsulated, sub-epidermal nodule filled with keratin material. This is one of the commonest masses seen in the eyelid.
Blepharoplasty is the removal and repositioning of the skin, muscle and fat of the upper and/or lower eyelid. In the lower eyelid the incision is made along the skin just beneath the eyelashes or in the moist surface of the eyelid known as conjunctiva. This involves repositioning of prolapsed orbital fat on both sides by draping the fat to the orbital rim area- which gives an aesthetically better appearance. This technique is done with an incision on the inside of the eyelid without a skin incision making the surgery “scarless”.
Blepharoplasty is the removal and repositioning of the skin, muscle and fat of the upper and/or lower eyelid. In the upper eyelid the incision is made and hidden in the natural lid crease. In the lower eyelid the incision is made along the skin just beneath the eyelashes or in the moist surface of the eyelid known as conjunctiva.
BCC is one of the commonest eyelid malignancies in India. While in the west, BCC accounts for nearly 90% of the eyelid malignancies, in the Indian subcontinent, BCC cedes it’s top position to Sebaceous cell carcinoma in India. BCC is a non-melanocytic cancer of the skin arising from basal cells of the epidermis. It is mostly seen on sun exposed areas, particularly in the head and neck region. BCC is caused by skin damage caused by prolonged exposure to ultraviolet light thus explaining the preponderance of this cancer in Caucasian skin which does not have the protective effect of melanin.
Blepharophimosis syndrome is also knows as BPES (Blepharophimosis, Ptosis, Epicanthus Inversus Syndrome). It is an autosomal dominant condition usually inherited from parents but not always.