Ocular Surface Squamous Neoplasia (OSSN) is a spectrum of pre-cancerous and cancerous lesions of the conjunctival epithelium (transparent coat covering the surface of the eye).
This condition can be diagnosed clinically and if promptly treated can achieve complete cure.
A #Customized ocular prosthesis (prosthetic eye) 👁️ surgery is considered when we have to remove an #eye due to one of the following reasons:
1. Eye Cancer (for example Retinoblastoma in children)
2. Irreparable eye injury due to trauma (children & adults)
3. Cosmetically disfigured eyeball with no hope of visual rehabilitation and which may or may not be painful.
It is not often that an eye surgeon is able to awe a room full of medical students and residents in a busy Ophthalmology clinic. So I’ll take this opportunity to write the story about this this extra-ordinary accomplishment.
Ocular Myasthenia Gravis (OMG) is one of the conditions that an oculoplastic surgeon can correct without surgery or any invasive intervention. It is a very satisfying to treat a patient of OMG provided the diagnosis is accurate. It has the rare distinction of being both under-diagnosed and over-investigated in different settings. Clinical examination is the cornerstone of a diagnosis of OMG. The various fancy but expensive testing can only corroborate a strong clinical suspicion
Ptosis can be easily treated with a day care, single sitting surgery and sometimes there need not even be a external skin incision. The surgery is known as conjunctivo-mullerectomy where the ptosis (droopy eyelid) is corrected using an incision on the wet surface of the eyelid.
Entropion is in common language inward turning of the eyelid margin. This causes trichiasis (lash-cornea touch), where the eyelashes are directed inwards toward the globe. This malposition can cause corneal irritation due to constant touch by the lashes.
Once the incision wound had completely healed, it was like he never had a surgery. Even the patient himself couldn’t locate the scar. The is the benefit of a minimally invasive surgery and aesthetically planned surgery. Even though the entire orbital lobe of the lacrimal gland was excised, there was no dry eye in the patient. This is because most of the regular lacrimation is by minor lacrimal glands spread out throughout the conjunctiva (transparent layer on the eyeball).
This young patient had suffered trauma to one of his eyes in childhood and wanted a cosmetic artificial eye which looked just like his other seeing eye. He underwent a customised ocular prosthesis surgery. Needless to say he was very happy with the outcome.
The histopathology of the mass turned out to be characteristic of tissue infected with Mycobacterium Tuberculosis. In the sub-continent, tuberculosis (TB) is always a differential even when tests for TB turn out to be negative. Histopathology is gold standard for diagnosing TB. Orbital TB though not always a top clinical diagnosis it is not uncommon.