Eyes don’t see what the mind doesn’t know!

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. 

Catching the Moving Lid!

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

Your eyes reflects your personality

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.

Riding up the Lower lid!

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.

A Lot to cry about…… but finally tears of happiness!

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).

Which one is the real eye?

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.

Not all masses are tumours!

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.

Cancer Cancer go away! Don’t come another day!

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).

The Eye of Thyroid!

While acute symptoms have debilitating morbidity with sight threatening features, the after effects of TED can have long lasting eye abnormalities like protruding eyeballs, squint, staring look and inability to close eyes causing eye dryness. Surgery can take care of many of these after effects.

An Eye for an Eye!

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.