Oculoplastic Surgery & Blepharoplasty in Sydney

What is oculoplastic surgery?

Oculoplastic surgery is a subspecialty of ophthalmology focused on the tissues around the eye. This includes the eyelids, tear ducts, eye socket, eyebrows and surrounding facial structures.

An oculoplastic ophthalmologist can assess conditions that affect eyelid position, tear drainage, the orbit or the tissues around the eye and determine whether observation, medical treatment or surgery is appropriate.

Oculoplastic ophthalmology combines specialist eye care with reconstructive and, in selected cases, cosmetic surgery around the eyes. Treatment may be recommended to protect the eye, improve comfort or function, address disease or trauma, or change eyelid appearance where appropriate.

The most suitable treatment depends on the exact diagnosis, eye health, symptoms and whether the goal is functional, reconstructive or cosmetic.

Conditions and procedures

Droopy eyelids (ptosis)

Ptosis occurs when the upper eyelid sits lower than normal. It may affect one or both eyes and can sometimes interfere with the upper field of vision. Causes include ageing, stretching or weakness of the eyelid-lifting muscle, nerve problems, trauma or previous surgery.

Treatment depends on the cause and severity. In selected patients, ptosis surgery tightens or repositions the eyelid-lifting mechanism. It can often be performed under local anaesthetic in adults, and over- or under-correction are among the possible procedure-specific risks.

Blepharoplasty (upper or lower eyelid surgery)

Blepharoplasty removes or repositions excess eyelid skin and, where appropriate, fat or soft tissue. Upper-eyelid surgery may be considered when excess skin affects the visual field or causes functional symptoms. Blepharoplasty may also be performed for cosmetic reasons after individual assessment.

Functional and cosmetic blepharoplasty have different goals and may have different referral, funding and consent considerations. Upper-eyelid excess skin can sometimes interfere with vision.

Entropion and ectropion

Entropion occurs when the eyelid turns inward, allowing eyelashes or skin to rub against the surface of the eye. Ectropion occurs when the eyelid turns outward and may cause watering, irritation or exposure of the eye surface.

Lubricants or temporary measures may help some symptoms, but surgery may be recommended when eyelid position needs to be corrected or the eye surface is at risk.

Eyelid lesions and periocular skin cancer

Lumps, cysts and other eyelid lesions are common and are not always cancerous. Assessment may include clinical examination and, where required, biopsy or removal.

If a skin cancer affects the eyelid or surrounding tissues, treatment may include excision and eyelid reconstruction to remove disease while preserving eyelid function and protecting the eye.

Blocked tear ducts and DCR surgery

The tear-drainage system carries tears from the inner corner of the eyelids into the nose. A blocked tear duct can cause persistent watering, recurrent discharge or infections.

Treatment depends on the location and cause of the blockage. In selected adults, dacryocystorhinostomy (DCR) surgery creates a new drainage pathway between the tear sac and the nose. DCR may be performed externally through a small skin incision or endonasally through the nose, depending on the case and surgeon.

Thyroid eye disease

Thyroid eye disease can cause inflammation and swelling around the eyes, eyelid retraction, bulging of the eyes, double vision, dryness and, in severe cases, pressure on the optic nerve.

Management depends on whether the disease is active, the severity of symptoms and which structures are affected. Care may involve medical treatment, monitoring and selected orbital or eyelid surgery.

Orbital lesions, inflammation and tumours

The orbit is the bony socket containing the eye, eye muscles, nerves, blood vessels and surrounding tissues. Orbital conditions can cause bulging of the eye, pain, double vision, swelling or changes in vision.

Assessment may involve eye examination and imaging. Some conditions can be monitored or treated medically, while others require biopsy or orbital surgery.

Orbital trauma and blow-out fractures

Trauma can fracture the thin bones of the eye socket and may affect eye movement, facial sensation or the position of the eye. Treatment depends on the fracture, symptoms and whether eye muscles or orbital tissues are trapped.

Facial nerve palsy, blepharospasm and hemifacial spasm

Facial nerve weakness can affect eyelid closure and expose the surface of the eye. Blepharospasm causes involuntary eyelid closure, while hemifacial spasm causes involuntary contractions on one side of the face.

Management is tailored to the cause and severity and may include eye-surface protection, medical treatment or surgery. Specific prescription medicines, where clinically appropriate, are discussed during consultation rather than promoted in public advertising.

Anophthalmic socket and prosthetic eye care

People who have lost an eye or have an ocular prosthesis may require assessment of the eye socket, eyelids and implant. Oculoplastic care can address socket discomfort, implant or prosthesis-related problems and eyelid position where required.

Other oculoplastic procedures

Depending on the specialist and clinic, other procedures may include brow surgery, temporal artery biopsy and reconstruction after trauma or tumour treatment. If these services are relevant to you, contact the clinic to confirm availability.

When should I see an oculoplastic ophthalmologist?

Consider an oculoplastic assessment if you have:

• a drooping upper eyelid that affects vision or appearance
• an eyelid turning inward or outward
• persistent watering or recurrent tear-duct infections
• an eyelid lump, lesion or changing area of skin
• difficulty closing an eye because of facial nerve weakness
• involuntary eyelid or facial spasms
• bulging of the eye, double vision or symptoms associated with thyroid eye disease
• an orbital injury or fracture
• a known orbital lesion, inflammation or tumour
• problems related to an ocular prosthesis or eye socket

URGENT: Seek urgent medical assessment for sudden loss of vision, severe eye pain, major eye or facial trauma, rapidly increasing swelling, or a new bulging eye associated with reduced vision or other acute symptoms.

What happens at an oculoplastic consultation?

Your consultation may include:

• a review of your symptoms, medical history and previous eye or facial surgery
• visual-acuity and eye-health assessment
• examination of eyelid position, closure and movement
• assessment of tear drainage where relevant
• photographs or measurements for selected eyelid conditions
• review of CT, MRI or other imaging for orbital conditions where available
• discussion of non-surgical and surgical options, expected recovery and risks

What are the risks of oculoplastic surgery?

Risks depend on the procedure and your individual health. Possible risks can include bruising, swelling, bleeding, infection, scarring, asymmetry, dry or irritated eyes, temporary blurred vision, recurrence of the condition or the need for further treatment.

Some procedures have specific risks. For example, ptosis surgery can result in over- or under-correction, while eyelid-position surgery may occasionally need revision. Your ophthalmologist will explain the risks that apply to your proposed treatment before consent.

Functional vs cosmetic eyelid surgery

Some eyelid procedures are performed to improve function or protect the eye, while others are performed primarily to change appearance. In some patients, both functional and cosmetic concerns are present.

A consultation should establish the reason for treatment, realistic goals, alternatives and potential risks. Cosmetic procedures should not be presented as necessary for wellbeing or as guaranteed to achieve a particular appearance.

Book an oculoplastic assessment

If you have an eyelid, tear-duct or orbital concern, an oculoplastic assessment can help identify the cause and appropriate treatment options.

Contact personalEYES to confirm the appropriate oculoplastic specialist and clinic location for your condition. Call 1300 68 3937 or book online.