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).

Growing out of a Crack!

Dermoid cyst (also known as choristoma) is a benign tumor growing out of a embryonic suture line. The tumour consists of normal cells occurring in an abnormal location. It is usually diagnosed in children when it is first visible but it is not uncommon to have adults coming to the clinic to know if it can be removed.

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.

Need an Eyelid Please!

Coloboma can present with eyelid coloboma, iris coloboma or choroidal coloboma, a combination of the three or all three. Eyelid colobomas part of goldenhar syndrome is usually in the upper eyelid, resulting incomplete closure resulting in exposure keratopathy which can then turn into a corneal ulcer as in our case.

When one doesn’t want to stare!

The staring look of eyelid retraction in TED can be very awkward for patients while meeting people and in photos of themselves. This eyelid malposition can be easily corrected with a 30 minute procedure done under local anaesthesia with very predictable outcomes. This lady was very pleased with the outcome of the surgery as she’s back to her beautiful Pre-TED self.

A Hole in the Wall

There is a mystical hole in the wall – of the orbit. An ancient myth among oculoplastic and maxillofacial surgeons alike-that once an Orbito- zygomatico-maxillary complex (OZM) fracture or commonly known as ZMC fracture is reduced, the orbital floor fracture automatically gets reduced and there is no need to repair the floor of the orbit. This was classic textbook teaching. However, this is true of only a small percentage of ZMC fractures.