Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and requires due care before, during, and after a surgical procedure to minimize or prevent further damage. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. It continues to be a widely practiced class of surgery, with various techniques having been developed for treating eye problems.
An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. "Palpebral" means relating to the eyelids. Its key function is to regularly spread the tears and other secretions on the eye surface to keep it moist, since the cornea must be continuously moist. They keep the eyes from drying out when asleep. Moreover, the blink reflex protects the eye from foreign bodies. A set of specialized hairs known as lashes grow from the upper and lower eyelid margins to further protect the eye from dust and debris.
The nasolacrimal duct carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The opening of the nasolacrimal duct into the inferior nasal meatus of the nasal cavity is partially covered by a mucosal fold.
East Asian blepharoplasty, also known as double eyelid surgery, is a type of cosmetic surgery where the skin around the eye is reshaped (blepharoplasty). The purpose of the procedure is to create an upper eyelid with a crease from an eyelid that is naturally without a crease.
Dermatochalasis is a medical condition, defined as an excess of skin in the upper or lower eyelid, also known as "baggy eyes." It may be either an acquired or a congenital condition. It is generally treated with blepharoplasty.
The canthus is either corner of the eye where the upper and lower eyelids meet. More specifically, the inner and outer canthi are, respectively, the medial and lateral ends/angles of the palpebral fissure.
Blepharoplasty is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper portion of the cheek. The procedure is more common among women, who accounted for approximately 85% of blepharoplasty procedures in 2014 in the US and 88% of such procedures in the UK.
The lacrimal sac or lachrymal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi, which drain tears from the eye's surface, and the nasolacrimal duct, which conveys this fluid into the nasal cavity. Lacrimal sac occlusion leads to dacryocystitis.
The posterior lacrimal crest is a vertical bony ridge on the orbital surface of the lacrimal bone. It divides the bone into two parts. It gives origin to the lacrimal part of the orbicularis oculi muscle.
The medial palpebral ligament is a ligament of the face. It attaches to the frontal process of the maxilla, the lacrimal groove, and the tarsus of each eyelid. It has a superficial (anterior) and a deep (posterior) layer, with many surrounding attachments. It connects the medial canthus of each eyelid to the medial part of the orbit. It is a useful point of fixation during eyelid reconstructive surgery.
Dacryocystorhinostomy (DCR) is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function.
Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. The term derives from the Greek dákryon (tear), cysta (sac), and -itis (inflammation). It causes pain, redness, and swelling over the inner aspect of the lower eyelid and epiphora. When nasolacrimal duct obstruction is secondary to a congenital barrier it is referred to as dacryocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae. The most common complication is corneal ulceration, frequently in association with S. pneumoniae. The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.
Epiphora is an overflow of tears onto the face, other than caused by normal crying. It is a clinical sign or condition that constitutes insufficient tear film drainage from the eyes, in that tears will drain down the face rather than through the nasolacrimal system.
Marsupialization is the surgical technique of cutting a slit into an abscess or cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst or abscess. Sutured in this fashion, the site remains open and can drain freely. This technique is used to treat a cyst or abscess when a single draining would not be effective and complete removal of the surrounding structure would not be desirable. The technique is often applied to Gartner's duct cysts, pancreatic cysts, pilonidal cysts, and Bartholin's cysts.
Dacryocystocele (Dacryocystitis) or timo cyst is a benign, bluish-gray mass in the inferomedial canthus that develops within a few days or weeks after birth. The uncommon condition forms as a result as a consequence of narrowing or obstruction of the nasolacrimal duct, usually during prenatal development. Nasolacrimal duct obstruction disrupts the lacrimal drainage system, eventually creating a swelling cyst in the lacrimal sac area by the nasal cavity. The location of the cyst can cause respiratory dysfunction, compromising the airway. The obstruction ultimately leads to epiphora, an abundance of tear production.
Raman Malhotra is a British ophthalmologist and oculoplastic surgeon. He is a consultant ophthalmic surgeon and head of the Corneoplastic unit, Queen Victoria Hospital, East Grinstead.
The accessory visual structures are the protecting and supporting structures (adnexa) of the eye, including the eyebrow, eyelids, and lacrimal apparatus. The eyebrows, eyelids, eyelashes, lacrimal gland and drainage apparatus all play a crucial role with regards to globe protection, lubrication, and minimizing the risk of ocular infection. The adnexal structures also help to keep the cornea moist and clean.
Nasolacrimal duct obstruction is the obstruction of the nasolacrimal duct and may be either congenital or acquired. Obstruction of the nasolacrimal duct leads to the excess overflow of tears called epiphora.
Exposure keratopathy is medical condition affecting the cornea of eyes. It can lead to corneal ulceration and permanent loss of vision due to corneal opacity.
Canthotomy is a surgical procedure where the lateral canthus, or corner, of the eye is cut to relieve the fluid pressure inside or behind the eye, known as intraocular pressure (IOC). The procedure is typically done in emergency situations when the intraocular pressure becomes too high, which can damage the optic nerve and lead to blindness if left untreated.
