Eye plastic and reconstructive surgery, a specialized area of ophthalmology that focuses on the Corrective and Reconstructive surgeries of eyelids and the structures surrounding the eye, eyebrows, forehead, cheeks, orbit (bony cavity around the eye), and lacrimal (tear) system.

Ptosis/ Drooping of Upper Eyelid: Ptosis may be congenital (present since birth), or occur as a result of injury, muscle disorder, nerve disorder, or due to aging. The Upper eyelid, which normally rests 1-2 mm below the upper black part of the eye, falls downward. In severe cases it may fall below the central part of the eye leading to visual disturbance. In children it may hinder normal eye development and cause lazy (amblyopic) eyes. Surgery can correct this problem by repairing the muscle that lifts the eyelid. Several surgical options are available, and the type of surgery used depends upon the severity of the droop.

Lid Malpositions: The upper and lower eyelid may be turned inward (Entropion) or outward (Ectropion), due to a number of factors. Apart from being a cosmetic blemish- they can cause watering and intolerance to light. In severe conditions the cornea is also affected due to exposure in ectropion or rubbing of lashes over the cornea in entropion. Depending on the cause and extent of the problem, surgical correction can be done.

Eyelid Tumours: Eyelid tumors are skin tumors that develop on the upper or lower eyelids or in the skin around the eyes. They can be benign (non-invasive) or malignant (invasive). They account for 5-10 % of all skin tumours. Benign eyelid tumors are very common and rarely become malignant. Malignant eyelid tumors are less common but very invasive and need to be tackled immediately with excision and biopsy

Trauma: Trauma due to injuries, assault and accidents can affect the eyelid, eyeball and the surrounding bones (fractures) depending upon the mechanism and force of injury. Eyelid is a delicate structure and if injured, needs meticulous suturing to preserve its normal shape and function. Injury to the tear ducts (canaliculus), which forms the pathway for drainage of tears within the eyelids, require special placement of silicone tubes within them to keep them open while the injured eyelid heals to prevent persistent watering. Fractures of the bones of the orbit may cause enophthalmos (eye appears sunken/ small), which may lead to a facial deformity, poor eye movement, or loss of vision. Surgical correction may be necessary in a few cases.

Thyroid eye disease: Thyroid eye disease/ Graves eye disease, causes the eyes to bulge forward (Proptosis) and the eye aperture to widen. It can lead to double vision, swelling around the eyes, discomfort, and in severe cases loss of vision. The initial (active) phase of thyroid eye disease involves frequent swelling of tissues around the eyes, double vision, and even reduction in vision in severe cases. Active phase is treated with medications (commonly Steroids) to reduce the swelling. Fortunately, the active phase of most thyroid eye disease patients ends in 18-24 months. However, the deformities (raised eyelid, prominent eyeball, or squint) may persist, and require surgery in the second (inactive) phase.

Decompression surgery, eyelid surgery, and eye muscle (squint) surgery is performed during the inactive phase. Your specialist will evaluate you to find out which phase you are in, and plan your treatment accordingly

Disorders of the Lacrimal Drainage System: Fluid/ Tears which are present on the surface of the eye normally drain out through the lacrimal drainage system, present on the medial side of the eye, into the nasal cavity. Obstruction of any part of this drainage system leads to persistent watering and repeated infections. It may be present since birth, a condition called Congenital NasoLacrimal Duct (NLD) Obstruction, which in many cases is managed conservatively with massage and eye drops. In unresolved cases the pathway is opened by the means of Probing or in later stages by Dacrocystorhinostomy. In adults, the NLD is blocked leading to accumulation of fluid in the lacrimal sac, and infection of the lacrimal sac, a condition called Dacryocystitis. This condition needs to be managed surgically by surgery.