Finding a road to the fistula

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.

The Dumbbell on the Eyelid

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.

Eyebags of Worry- Trans-conjunctival Lower lid Blepharoplasty

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- Eyelid Lift Surgery

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.

An Eye for an Eye- Customised Ocular Prosthesis

A 48 year old patient had a painfully blind right eye for which he wanted resolution with best aesthetic outcome.

When will Artificial Intelligence replace Human Doctors?

AI robots will be complementary to human doctors and won’t be a zero-sum game for a long time to come. AIs will help us reduce our mistakes, decrease our workload, make us work more sane hours and in turn manage our work-life balance- but at least in the foreseeable future they aren’t going to replace us. Maybe it will lead to lot of us doing less mundane, repetitive jobs and with doctors doing much higher intellectual level work.

The rodent that dug into the eyelid! Basal Cell Carcinoma

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.

The Dog and the Eyebrow! Eyebrow Reconstruction

The Eyebrow is a unique facial aesthetic unit and it’s importance to the face is apparent only when it is disfigured with loss of the hair bearing skin like in this case. Likewise, reconstruction of the eyebrow is challenging because the thickness and direction of the eyebrow hair which is unique and not easy to replicate with hair transplants from other hair bearing areas.

Tumour Behind the eye! Intra-conal Orbital Cavernous Hemangioma

In an earlier era, these tumours would be removed via a craniotomy (brain surgery) by neurosurgeons or a disfiguring open surgery sometimes causing the loss of vision in the involved eye by other surgeons- that’s way too much morbidity for a benign tumour. But with the advent of modern day techniques and skilled oculoplastic surgeons performing orbitotomy today to remove such tumours, this surgery’s risks and complications is very low with the added advantage of a scarless as well as without even having to remove bone. This surgery is followed by a mostly uneventful recovery period.

OSSN- Cancer of the surface of the eye!

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 good news is that, this type of cancer can be completely cured by surgery and/or chemotherapy eye drops if diagnosed before it becomes an invasive Squamous Cell Carcinoma.