- Ptosis
- Entropion
- Ectropion
- Tearing or Epiphora
- Dry Eye
- Skin Cancer and Orbital Tumors
- Thyroid Eye Disease
- Chalazia
- Removal of an Eye or Enucleation
- Trauma
- Congenital Disorders
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Oculofacial Cosmetic and Reconstructive Surgery, also referred to as Oculoplastic Surgery, incorporates a wide range of aesthetic and medical services, such as surgery of the eyelids, eyebrows, mid-face and orbital areas (including tear duct surgery, thyroid eye disease, fractures and tumors), as well as facial rejuvenation procedures such as Botox®, Restylane®, microdermabrasion, facial peels, and skin care treatments. Whether you are seeking medical or cosmetic services, the goal is to address your particular needs while simultaneously achieving a natural, harmonious look to complement your individual features. It is essential to schedule a thorough consultation with Dr. Zwick, our Oculoplastic specialist, to evaluate your specific needs and determine a personalized plan to achieve successful results for you.
Oculofacial surgery covers a broad scope of reconstructive procedures. Some of these services include eyelid surgery; repair to the structures of the eyelids damaged by accident, birth defect, or aging; removal of non-functioning eyes; artificial eye implants, correction of tearing and lacrimal disorders; eyelid scar revision; orbital fracture repairs; eyelid cancer and orbital tumor removals; and thyroid eye disease. Because of the unique structure of the orbital area, it is essential to have a skilled surgeon perform these services. Since Oculofacial surgeons receive specialized training, they are often called upon by other surgeons, such as plastic surgeons, to address issues within the orbital area.
Ptosis is the term for droopy, sagging eyelids. As we age, the muscles that hold up our eyelids loosen and cause our lids to droop. Not only can this give you a tired look, but the drooping eyelids can also block your vision and cause eye fatigue. Some people experience brow or forehead aches and fatigue at the end of the day as they constantly raise their brows to see. Although Ptosis may be the result of aging, it may also be caused by an injury, birth defect, or neurological disorder. Adults, as well as children, may be diagnosed with ptosis.
Fortunately, droopy lids can be repaired by an outpatient surgical procedure that is conducted in our private surgery center located next to our main office in Annapolis. We have successfully lifted many patients’ eyelids to improve their vision and give them a more refreshed look.
Entropion is a condition in which your lower eyelid turns inward. This can cause irritation to your eye and result in excessive tearing, crusting, mucous discharge, and even vision loss. Although most commonly the result of aging and the weakening of your eyelid muscles, entropion of the eyelids may also be caused by a birth defect, eye injury, scarring, or tumors.
Patients whose eyelids turn inward can undergo an outpatient surgical procedure to tighten the eyelid and return it to its normal position. For those cases where whom surgery is not an option, we can treat this condition with lubricating drops and ointments, as well as offer temporary sutures to help alleviate the problem. Since entropion of the eyelids can cause damage to the outer part of the eye, known as the cornea, we highly suggest you schedule an appointment with our Oculoplastic Surgeon Dr. Zwick for an evaluation.
Ectropion is a condition in which your lower eyelid turns outward. This condition can cause irritation to your eye and result in excessive tearing, crusting, and mucous discharge. Although most commonly the result of aging and the weakening of your eyelid muscles, ectropion of the eyelids may also be caused by a birth defect, eye injury, scarring, or skin cancers.
Patients whose eyelids turn outwards can undergo an outpatient surgical procedure to tighten the eyelid and return it to its normal position. To prevent dryness of the cornea, artificial tears and ointments may be prescribed to help keep your eyes lubricated.
Since ectropion of the eyelids can cause damage to the outer part of your eye, known as the cornea, we highly suggest you schedule an appointment with our Oculoplastic Surgeon Dr. Zwick for an evaluation.
Excessive tearing can result from faulty tear drainage into the lacrimal tear ducts or from overproduction of tears from the lacrimal gland. A common cause of tearing is the blockage of the lacrimal (tear) ducts located alongside the nose, which may result from inflammation, injury, tumors, or other reasons. Excess tearing can be a nuisance and can also cause infection that may affect vision if untreated.
Tearing can frequently occur in infants. With medical therapy and massage, the obstruction is often resolved. If tearing persists after one year of life, probing and irrigation of the lacrimal system is recommended. If there is recurrence, children may require a small silicone stent to be placed into the tear drainage system. In adults, nasolacrimal duct obstruction often requires a procedure called dacryocystorhinostomy (DCR) which creates an opening from the tear duct into the nose. Another option is an artificial tear duct implant, called a Jones Tube.
Dry Eye is an extremely common problem that adults experience. When your eyes are not well lubricated, they become irritated causing blurred vision, eye fatigue, mucous discharge, and discomfort. There are several causes for dry eye, including age, environmental factors such as smoke, dust, allergens, and medical conditions like pregnancy, menopause, rheumatoid arthritis, Bell’s palsy, and vitamin A deficiency. Advanced research offers a variety of artificial tears and ointments that help keep eyes lubricated and reduce discomfort. If this is not sufficient, patients may require plugging of the lacrimal puncta, or permanent closure of the lacrimal ducts.
Skin Cancer and Orbital Tumors
Skin cancer is common in many races and ethnic groups, especially Caucasians and patients exposed to the sun. Eyelid skin cancer occurs frequently on the lower eyelid and usually starts as painless elevations or nodules with some loss of eyelashes or distortion of the eyelid margin. Skin cancer may ulcerate or bleed and distort the eyelid architecture. It is important to have these lesions examined early. Dr. Zwick can remove the eyelid cancer and reconstruct the eyelid. Some cancers in other parts of the body can spread to the orbit around the eye. Orbital tumors occur behind the eyelids around the eye and can be malignant or benign. If the tumor extends into the brain or sinuses, a team approach to remove the tumor by Oculoplastic surgeons, Neurosurgeons and ENT surgeons is often necessary.
Thyroid eye disease usually occurs as a result of Graves disease, or hyperthyroidism; yet, it can also affect hypothyroid or euthyroid patients. Infiltration of the muscles and tissues surrounding the eye can cause poor eye movement, proptosis, or bulging of the eyes, and eyelid malpositioning and visual loss. The most common sign of thyroid eye disease is eyelid retraction. Management of patients with this disease is often multidisciplinary and includes endocrinologists, internists, strabismus surgeons, ophthalmologists, and oculoplastic surgeons. Patients with severe sight-threatening progression of the disease often require high-dose steroid treatment, radiation therapy, or surgery to decompress the eye and preserve sight. Patients may also require surgery to straighten the muscles that move the eye and eyelid.
A chalazion is a cyst that develops as a result of trapped oil secretions in one of the hundreds of glands in the upper or lower eyelids. A chalazion can arise initially as a tender, red, swollen bump, resembling a stye or infection of the eyelid. Treatment includes warm compresses, massage, and sometimes antibiotic topical cream or drops. After a few days, a painless firm bump on the eyelid often results. Chalazia typically spontaneously resolve within a few weeks to a few months. When a chalazion persists for longer than 6 weeks, it can be excised in the doctor's office by an easy procedure. Associated conditions with chalazia include rosacea, acne, dry eye, seborrhea, and blepharitis.
Removal of an Eye or Enucleation
Removal of an eye, or enucleation, is often necessary due to injury, tumor, or disease. The loss of an eye is significant and unpleasant. A prosthetic eye can often replace a non-functioning eye, look very natural and movement can often be maintained. Though people can wear a prosthetic eye for several years without complications, some side effects may need surgical and medical attention. Poor fit of the prosthesis, sagging of the eyelids, loss of shape of the eye socket, or migration or infection of the implant may require revision or replacement. Usually, the final results are aesthetically pleasing to the patient.
Trauma to the eyelids and bony orbits often requires surgical repair by an oculoplastic specialist for an optimal functional and aesthetic result. Orbital trauma often results from car accidents or sports injuries. Restoring the bony orbit around the eyes is important for eye positioning and vision. Scar tissue can result from injury or surgery which may be unsightly or deforming to the eyelid. Scarring can cause poor function and closure of the eyelid, notching of the eyelid margin, drooping eyelids, misdirected lashes, and ultimately, irritation to the eye. Scar revision can be addressed with reconstructive surgery to improve these problems.
A variety of congenital disorders can involve the eyelids, lacrimal system and orbits including congenital ptosis, nasolacrimal duct obstruction, dermoid cysts, eyelid malformations, and craniofacial defects. Many of these disorders can be isolated and surgically repaired, while others can be a part of a syndrome of disorders. These patients often require the care of several specialists.