Ocular Plastics

What are Ocular Plastics

Ocular Plastics are the reconstructive surgery of the orbit (eye socket), eyelids, tear ducts, and the face addressing problems primarily related to the tissues surrounding the eye, rather than the actual eye itself. Such conditions may include the following:

  • Peri–ocular; surrounding area of the eye, not including the eyeball
  • Eye lash abnormalities
  • Artificial eye
  • Orbital tumour’s and inflammation
  • Trauma and reconstruction
  • Eyelid conditions:
  • Ectropion
  • Entropion
  • Ptosis
  • Dermatochalasis
  • Lid retraction

The importance of wearing sunglasses has become more emphasised in recent years particular for the protection of the eye however it is just important for the protection of the eyelid and the surrounding area. Eyelids are at particular risk of sun-exposure related skin cancers. The eyelids are the same as any other part of the body in relation to the possibility of developing any benign or malignant lesions. It is additionally difficult to remove the lesions as the structure of the eyelid is to protect the eye and in removing the lesion the ophthalmologist must ensure there is enough skin to cover and protect the eye.

Eyelid Conditions
  • Ectropion is the turning out of the eyelid. Usually occurring in the lower eyelid, it turns away from the eye, exposing the inner surface. Dry, painful eyes may be experienced and an increased opportunity for foreign material to enter the eye.
  • Entropion is where the eyelid turns inward toward the eye. Usually occurring in the lower eyelid where it causes the eyelashes to continually rub against the surface of the eye. Dry, painful eyes may be experienced and a decrease in vision may occur if the cornea is damaged.
  • Ptosis is a condition where the upper eyelid droops over the eye blocking the upper field of vision. It is commonly known as ‘drooping eyelid’ and occurs when there is a weakness in the muscles responsible for raising the eyelid.
  • Dermatochalasis is a condition where excess skin occurs in both the upper and lower eyelid. It often restricts the peripheral vision and can be an acquired condition or congenital.
  • Lid retraction can occur in both the upper or lower eyelid. It can give the appearance of a stare or a surprised look and may cause the inability to close the eye fully allowing the surface to dry out. As the cornea is nourished by the production of tears the drying out may damaged the cornea and will cause discomfort to the eye.
Artificial Eyes

Unfortunately, sometimes, eyes must be removed due to trauma, tumours, or other eye pathology. Removal of a blind, painful or unsightly eye and replacing it with an artificial eye often provides significant relief. A ball of plastic or coral is placed internally to replace the eye, whilst a removable/cleanable disc is placed superficially between the eyelids. This disc is painted by an Ocularist to match the other eye exactly providing excellent cosmetic results.

Orbital Tumours and Inflammation

The structures surrounding the eye including the muscles, tendons, glands, fat, even the linings of the eye itself can become inflamed or may be involved in, or compressed by a tumour. Often this will manifest itself as the eye protruding forwards or sideways.

Trauma and Reconstruction

The bones surrounding the eye can be involved in trauma. The most common scenario is called a “blow-out fracture” of the walls beneath the eye and those on the nasal side of the eye. Sometimes muscles can be pulled into the breaks causing double vision.

The eyelids can also be involved in trauma, and require specific reconstruction to maintain their proper structure and function.

Brow Ptosis

Brow Ptosis is a condition where the eyebrows drop downwards due to stretching of the forehead skin with age, or due to problems with the nerves in the area. It can give the appearance of frowning or sadness, and can lead to difficulties with opening the eyelids.