Whilst most people are familiar with seeing their ophthalmologist for their cataracts and concerns within the eye, a vast array of injury, illness or changes to anatomy can affect the supporting structures around the eye – the adnexal or extraocular tissues. These conditions can be very debilitating for patients and may even lead to blindness. The following conditions are some of the more common presentations for extraocular eye specialists. Eyelid function The eyelid is an extremely important part of the eye anatomy. Without healthy functioning eyelids, the eye cannot serve well as a visual organ – the corneal surface of the eye gets exposed and dry, becomes scarred or is at risk of serious infections. The eye can ultimately lose vision, become painful and sometimes cannot be preserved. If the eyelids function but are droopy, a person’s field of vision can be significantly reduced. Watery eyes Patients may experience annoying watery eye symptoms if the eye surface is dry, the eyelids are lax or the tear duct drainage system through to the nose is blocked. Imagine looking through a water level when trying to play golf, drive a car or read a book and it gives you some indication of how frustrating a condition like this can be. Cancer Skin cancer is another issue that ophthalmologists are faced with, especially in Queensland. Statistically, people living in Queensland have the highest chance in the world of developing a skin cancer. Approximately 50% of skin cancers are found on the face or neck, due to sun exposure, and many are around the eyelid region. This can be a delicate procedure to remove and due to the skin cancer’s location, patients are often worried about visual scarring and defects as a result. Trauma On the Gold Coast, ophthalmologists see a broad range of trauma. Any problem that changes the volume of the bony orbital socket, or any changes within the orbit, can cause the eye to become altered in position or misaligned with the other eye. This can cause significant visual distress. Orbital Conditions Common conditions which occur in the eye socket (or orbital conditions) include thyroid eye disease, orbital inflammations, tumors and secondary traumas. Sometimes these conditions need surgery to fix the problem. Oculoplastic and reconstructive surgery includes a wide variety of surgical procedures that deal with problems in the eye socket, eyelids, tear ducts, some areas of the face and any extraocular tissues. Some of the most common conditions which need oculoplastics are: • Droopy eyelids and excess skin (ptosis or dermatochalasis). • Upper and lower lid malpositions (entropion and ectropion). • Skin cancers requiring eyelid reconstructive work. Whilst the majority of small lumps on the eyelid are benign, sometimes eyelid tumors can be aggressive and spreading. Patients with extensive cancers require the combined approach of a multidisciplinary specialty head and neck team to provide the overall best care. • Occasionally, when an eye has had complex problems either due to trauma or pathology and becomes blind and painful, removal of the eye (enucleation or evisceration surgery) may allow pain relief and a speedier rehabilitation back into normal activities. Whilst often a very distressing decision for a patient to make, the end result and cosmetic outcome can be markedly superior to the prior non-sighted scarred and painful eye. • Watery eye symptoms require a thorough examination as to the cause of the symptoms and may require simple lid hygiene or tear film measures, eyelid tightening procedures or nasolacrimal surgery, either via external or endonasal approaches. Pindara Magazine 48 2017
Pindara Private Hospital Magazine - Issue Ten
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