SURGICAL TREATMENTS & PROCEDURES
The information outlined below on treatments and procedures on the eye is provided as a guide only and it is not intended to be comprehensive.
Discussion with Raji is important to answer any questions that you may have. For information about any additional treatments not featured within the site, please contact us for more information.
How can I reduce wrinkles?
Botulinum toxin is a muscle relaxant that has been used for many years for the cosmetic treatment of wrinkles. The two main types are Botox® and Dysport®. It also has other uses such as in facial palsy, corneal exposure and certain types of squint.
Which areas of my face can be treated?
Botulinum toxin is most often used to treat the upper face including the forehead lines and frown lines (glabella region) in the lower central forehead and bunny lines on the nose. It can be used around the eyes (pericoular region) to treat crows feet and lower eyelid wrinkles. In selected cases Botulinum toxin can be used to raise the eyebrow. The lower face can also be treated to improve lines around the mouth and chin where appropriate.
What is the difference between Botox® and Dysport®?
Botox and Dysport are very similar. They are both FDA approved and are a type of botulinum type A used to relax the muscles with a good safety profile. Both types of treatment take 2-3 days to take effect and you normally need to repeat treatments every 3-4 months depending on your sensitivity.
How does the treatment work?
Botulinum toxin is a neurotoxin that weakens the muscle in to which it is injected. It acts be blocking the communication between the nerve and the muscle.
How is Botulinum toxin given?
Botulinum toxin is given as an injection in the clinic room using a very fine needle. Small volumes are injected beneath the skin to the specific muscles around the eye and face that need treatment. We often advise the use of ice packs after treatments to prevent bruising and minimise pain.
Who carries out the treatments?
Raji carries out all treatments personally providing a discrete and bespoke approach.
What are the side effects of the treatment?
The side effects of Botox® or Dysport® are:
You may develop some subtle redness around the area of the injection and occasionally some bruising which is quite common.
Rare complications include:
- A squint with double vision
- Drooping of the face
- Drooping of the upper eyelid
- Blurred vision
Very rare complications include:
- An allergy to the treatment
- A change in your voice
- Loss of bladder control
- Difficulty swallowing
This type of treatment does not have long term follow-up over decades and we do not know the long term impact if using Botulinum Toxin over many years.
Please note: This list does not include all the possible complications of using botulinum toxin.
Ectropion
What is an ectropion?
An ectropion is an out-turning of the eyelashes. There are many causes for this although the most common is laxity of the eyelid often associated with age. Other causes include facial palsy, scarring of the skin and lesions affecting the eyelid. These would be discussed with you during your consultation if present.
An ectropion can cause the irritation to the eye and occasionally will reduce your vision. This is usually because the tear film is not in the correct position to protect the eye.
What is the treatment?
The mainstay of treatment is surgery which is aimed at correcting the position of the eyelid.
We normally perform your surgery under local anaesthetic which is given in the operating room. Occasionally we can give sedation at the same time if you are uncomfortable about having a local anaesthetic on its own.
The surgery itself involves making a small incision to the skin on the outer aspect of your eye socket. These incisions are made to be hidden within your natural skin creases. The eyelid is repositioned and attached to the outer aspect of the eye socket. Tap image to enlarge.
On occasion we may need to put extra stitches on the inside of the lower eyelid. The sutures we use are dissolvable but sometimes they still need to be removed in clinic.
The surgery normally takes about 30 minutes per eyelid but can sometimes take longer. This type of surgery is usually performed as a day case operation and we normally allow you to go home about 30 minutes after you surgery is finished.
What are the risks of surgery?
The risks of surgery include postoperative bleeding, scarring to the eyelids and infection. We advise that you use an antiobiotic ointment after the surgery (see below) to help reduce the risk of infection.
Occasionally we may under or over correct the amount of skin that we remove and this can result in a different appearance between the eyelids. Sometimes the scar line can be slightly irregular with occasional small white cysts forming. Most of these complications can be corrected if needs be with a second operation.
The most serious risk of any eyelid surgery performed is damage to your eyesight. Fortunately this risk is extremely rare.
What can I expect after surgery?
The eyelids will be bruised after surgery and you may have some bloodstained tears which is quite normal initially.
You should avoid any strenuous activity including lifting heavy objects for a least a week and avoid swimming for three weeks after surgery.
What do I need to do after surgery
You should avoid any strenuous activity including lifting heavy objects for at least two weeks and avoid swimming for three weeks after surgery.
We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection and to help lubricate the eyes for two weeks
We advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.
We normally see you after surgery to check the position of the eyelid.
Entropion
What is an entropion?
An entropion is an in-turning of the eyelashes. There are many causes for this although the most common is laxity of the eyelid often associated with age. Other causes usually involve scarring to the eyelids
An entropion will cause the eye lashes to rub the eye which often causes irritation and can affect your vision (tap to enlarge).
What is the treatment?
The mainstay of treatment is surgery which is aimed at correcting the position of the eyelid. Whilst you are on the waiting list to have the surgery performed we advise that you tape your eyelid to the cheek (tap images to enlarge).
You can also use lubricants in the eye. These measures will help reduce the eye lashes irritating the eye.
We normally perform your surgery under local anaesthetic which is given in the operating room. Occasionally we can give sedation at the same time if you are uncomfortable about having a local anaesthetic on its own.
The surgery itself involves everting the eyelid and tightening it to prevent the entropion from returning. Tap to enlarge image.
The scar line runs underneath the eyelash line and there is a second small incision to the skin at the outer edge of your lower eyelid. These incisions are designed to be hidden within your natural skin creases. Tap to enlarge image.
The sutures we use are dissolvable but sometimes they still need to be removed in clinic.
The surgery normally takes about 25 minutes per eyelid but can sometimes take longer.
What happens before surgery?
Prior to surgery the team will see you in clinic and discuss the treatment options with you at this stage. If you are happy to go ahead with surgery we will normally consent you for the procedure and you will need to sign a form.
You may then need to be pre-assessed for the surgery whereby a nurse will ask you some questions about your general health should the doctor feel that this is necessary. On occasion we may take some blood tests and may ask you change your medications prior to surgery. The pre-assessment may take place on the day of your clinic visit, on a subsequent day or even over the telephone.
What are the risks of surgery?
The risks of surgery include postoperative bleeding, scarring to the eyelids and infection. We advise that you use an antibiotic ointment after the surgery (see below) to help reduce the risk of infection. Occasionally we may under or over correct the position of the eyelid. During the surgery we put some stitches near the bone on the outside of the eye socket, rarely patients can complain of tenderness in the area of this stitch. Most of these complications can be corrected if needs be with a second operation.
The most serious risk of any eyelid surgery performed is damage to your eyesight. Fortunately this risk is extremely rare.
What happens on the day of surgery?
On the day of surgery you will be told a time and place to come to the hospital. You will be met by the nursing team and one of the surgical team will also see you.
If you are booked for day case surgery you will need to make sure that someone can be with you on the evening of surgery. If you are coming to stay the night you will need to bring some overnight clothes and toiletries for the duration of your stay. We advise that you also bring in your medications with you when you come into hospital.
Sometimes you may have to wait for a few hours before your surgery is performed and this depends on your position on the operating list.
What can I expect after surgery?
The eyelids will be bruised after surgery and you may have some bloodstained tears which is quite normal initially.
The eyelid will often look quite tight for the first couple of weeks. This settles down as the eyelid relaxes into its normal position much like a leather belt stretching after you have worn it for a few days.
What do I need to do after surgery?
Normally we ask that you keep the wounds around your eye clean after surgery. You can clean the wound by allowing boiled water to cool and gently dabbing the wounds with a cotton bud.
We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection and to help lubricate the eyes for two weeks.
We normally advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.
We normally see you 1-2 weeks after surgery to remove any sutures.
You should avoid any strenuous activity including lifting heavy objects for a least two weeks and avoid swimming for three weeks after surgery.
Blepharoplasty
Eyelid surgery (blepharoplasty) is cosmetic surgery to remove excess skin or fat from the eyelids.
The aim is to improve hooded or drooping eyelids or eye bags.
Before you go ahead, be sure about your reasons for wanting eyelid surgery. Bear in mind the cost, the risks, and the fact the results cannot be guaranteed.
It’s a good idea to discuss your plans with a GP first. There might be a medical condition affecting your eyelids or a reason why the operation is not appropriate for you.
What does it involve?
A blepharoplasty can be done under local anaesthetic with sedation or under general anaesthetic.
The surgeon will need to know if you are taking any medicines to reduce your risk of blood clots, such as aspirin or warfarin.
Surgery on the upper eyelids generally involves:
- making a cut (incision) along the eyelid crease in the natural skin fold of the eyelid
- removing excess skin, fat or muscle
- closing the incision – the scar will usually be hidden in the natural fold of the eyelid
Surgery on the lower eyelids generally involves:
- making an incision either just below the lower eyelashes or on the inside of the lower eyelid
- repositioning or removing fat from the bags under the eyes, and sometimes also a small amount of skin
- supporting the muscles and tendon of the eyelid if necessary
- closing the incision
The surgeon will usually apply thin, sticky strips called suture strips to support the eyelids after surgery. These are usually removed up to 1 week later.
An upper blepharoplasty may take about 1 hour. Surgery on the lower lid may take up to 2 hours. Most patients can go home the same day.
Recovery
It’s advisable to take about 1 week off work to recover from eyelid surgery.
It may be obvious for a little longer than a week that you’ve just had eyelid surgery.
You will not be able to drive for a number of days after the operation. Bruises, scaring and redness may take several weeks to fade.
You will probably need to:
- prop your head up with pillows for a couple of days, when resting, to reduce swelling
- gently clean your eyelids using prescribed ointment or eyedrops
- hold a cold pack to your eye for a few days – try a packet of frozen peas wrapped in a tea towel
- wear sunglasses to protect your eyes from the sun and wind
- take paracetamol or another prescribed painkiller to relieve any mild pain
You should avoid:
- strenuous activity and swimming for a few days
- smoking, as smoke can irritate your eyes
- wearing contact lenses or rubbing your eyes
Side effects to expect
It’s common after eyelid surgery to temporarily have:
- puffy, numb eyelids that are difficult to close at night
- irritated, sensitive or watery eyes – this may last a few weeks
- bruising that looks like a black eye
- scars – these eventually fade to almost be invisible
Tear Duct Syringing
If you present with a watery eye we may need to syringe your tear duct. The aim is to find out whether or not you have a blockage in the tear system. The syringing is performed using a blunt cannula that is introduced into you tear duct and saline is injected into the tear system.
The aim firstly, is to see whether the cannula can be passed easily along the first part of the tear system (the cannaliculus) and secondly whether the saline will pass down the naso-lacrimal duct into you throat.
You will normally be able to taste some saltiness at the back of your throat.
Not all watery eyes are secondary to a blocked tear duct and in some cases the naso-lacrimal duct may be patent (i.e. saline can reach your throat) but may be narrowed or stenosed. Occasionally further imaging tests are used to identify a stenosed naso-lacrimal duct known as lacrimal scintillography.
If a blockage is identified you may require a DCR procedure. Raji will discuss with you at the time of review the best treatment for your particular problem.
Dacryocystorhinostomy (DCR) surgery
There are numerous procedures aimed at improving your watery eye which depend on the cause of the watering. In over a third of cases a watery eye is related to a blockage in the passage way between the eyelid and the nose. This passage way normally drains the tears from the eye into the nose at which point the tears pass into the throat and is known as the naso-lacrimal or tear duct.
What is DCR surgery?
The standard treatment for nasolacrimal duct obstruction (NLDO) is a dacryocystorhinostomy (DCR) procedure. This effectively bypasses the blockage in the tear duct by making a small hole in the bone on the side of your nose. The tears can then drain into the lacrimal sac and into the nose via newly fashioned pathway
This surgery can be performed either through a small incision on the side of the nose (external approach) or by using specialised endoscopes via the nose (endoscopic approach). Raji will discuss with you the best method for you in clinic .
What happens on the day of surgery?
On the day of surgery you will be asked to come into the hospital to undergo surgery. The surgery is performed usually under a general anaesthetic. If you are coming to stay the night you will need to bring some overnight clothes and toiletries for the duration of you stay. We advise that you also bring in your medications with you when you come into hospital.
What are the risks of surgery?
The risks of surgery include postoperative bleeding, scarring and infection. Nosebleeds are quite common after the surgery and we will monitor this. Rarely, we may need to pack the nose if the bleeding is significant.
The serious risks of the surgery are very rare. There have been reported cases of a CSF (cerebro-spinal fluid) leaks from where we make the hole in the bone and also injury to the eye.
What can I expect after the surgery?
The day after surgery you may have some bruising around the eye and some mild ooze from the nose. We would normally aim for you to be discharged on the first day after your sugery.
What do I need to do after the surgery?
You are advised not to blow your nose for two weeks after your surgery and to refrain from hot beverages for at least 48 hours after you surgery to prevent against further nose bleeds. You should avoid any strenuous activity including lifting heavy objects for a least a week and avoid swimming for three weeks after surgery.
We would aim to remove your stitches at 1-2 weeks. The silicone stent that sits in the nose is usually removed at 4-6 weeks after surgery.
We will give you some oral antibiotics, a nasal spray and an eyedrop to use and the instructions for these will be given to you. The nursing staff will help you with administering these treatments before you leave the hospital.
Punctoplasty
What is the punctum?
The punctum is the entrance to the tear duct and is found on both the upper and lower eyelid. It is easiest to think of it like a plug hole the which the tears need to drain to reach your tear duct and then your nose.
Why do I need my punctum enlarging?
In some cases the punctum is too small. This may prevent the tears from draining which can give you a watery eye.
When punctal stenosis is present we may need to enlarge your punctum by excising a small part of the tear duct. This is called a punctoplasty.
How is a punctoplasty performed?
A punctoplasty is usually performed in the treatment room in clinic. It is performed under local anaesthetic and will take about 5 to 10 minutes.
A small piece of the punctum is removed to allow the tears to pass more easily.
The tears should then start to drain more easily.
This will not usually lead to any visible scar but you may have a small bruise at the inner aspect of your lower eyelid for a few days.
What happens after the surgery?
After the surgery we will review you in clinic and may re-probe the tear duct with some anaesthetic drops. This ensures that the punctum does not close up afterwards.
You will have some drops to take for about two weeks.
What are the complications of a punctoplasty?
There are relatively few complications with this surgery. The main risk is that the eye may perstistently water afterwards. As with any surgery around the eye there is a theoretical risk of trauma to the eye or vision.
Orbital Biopsy
Raji can manage eye socket lesions including benign and malignant masses. This may require an orbital biopsy to diagnose a lesion before definitive management can take place. Raji will discuss with you in clinic the specifics relating to surgery.
In cases of eye socket masses you may need to be scanned at the hospital in the form of either a CT or an MRI scan. In some cases both scans will be needed.
Eye socket reconstruction
Eye socket reconstruction is usually required after eye removal. Patients may present with an asymmetrical appearance. The artificial eye may appear deep-set compared to the other side. The upper eyelid may appear sunken or lower than it should be.
What does the surgery normally involve?
In cases whereby there is not enough volume in the eye socket after eye removal we will often aim to increase the volume by either exchanging your current orbital implant for a larger one; this is known as a secondary orbital implant. In some cases a secondary orbital implant is not possible and the volume will be replaced using fat taken from the abdomen. This will be discussed with you when planning the surgery.
What can I expect after surgery?
Often after eye socket surgery your eye will be padded for 3-4 days. You will be booked for review within the first week to have the pad removed. In the first few days after surgery you will be prescribed an oral antibiotic. You may feel nauseous or even feint at times shortly after surgery to the eye socket.
On removing the pad you will be able to see a clear conformer (shell) in the eye socket which will stay in place for the initial 4-6 weeks. Your eyelids may be a little swollen and this will usually settle within a few days.
Raji will show you how to clean your eyelids and socket and how to apply an antibiotic ointment.
What do I need to do after surgery?
Normally we ask that you keep the wounds around your eye clean after surgery. You can clean the wound by allowing boiled water to cool and gently dabbing the wounds with a cotton bud.
We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection.
We do not normally need to remove any stitches unless you have had simultaneous eyelid surgery.
You should avoid any strenuous activity including lifting heavy objects for at least two weeks and avoid swimming for three weeks after surgery.
What is orbital decompression surgery?
Orbital decompression surgery helps patients with thyroid eye disease (TED). In TED the soft tissues within the eye socket can expand and this can cause the eye to move forwards.
This can potentially make the surface of the eye uncomfortable or cause pressure on the optic nerve that connects the eye to the brain. Decompression surgery increases the space within the eye socket to allow the eye to sit further back and to potentially reduce pressure on the nerve.
What does this involve?
Think of the problem as a bag of shopping that won’t all fit inside a cardboard box.
If holes are made in the sides of the box the shopping will fit inside and the lid can be closed.
Instead of a cardboard box we make holes in the wall of the eye socket. This often involves inner and outer walls but may also involve the floor of the eye socket. This allows the eye to sit further back where it is protected.
What are the risks of surgery?
The risks of surgery include bleeding, scarring and infection. We advise that you use antibiotics (as an ointment and tablet) after the surgery to help reduce the risk of infection. Some patients may experience worsening of their double vision after the surgery although this may improve after a few weeks. Numbness can also occur around the eye.
One can experience subtle vibrations in the vision (oscillopsia) when chewing food and this will often improve after a few weeks.
Serious risks include injury to major blood vessels, CSF leak and visual loss. Raji will discuss these with you in clinic. Fortunately these risks are extremely rare.
What can I expect after surgery?
The eyelids will be bruised after surgery. You will have a drain in place that will normally be removed on the first morning. You will see sutures in the upper eyelid extending to the side of the eye and these will be removed at between 1 and 2 weeks.
What do I need to do after surgery
You should avoid any strenuous activity including lifting heavy objects for a least a week and avoid swimming for three weeks after surgery. You should also try and avoid blowing your nose for a few days.
We advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.
We normally see you after surgery to check on the position of the eye.
What is punctal occlusion?
If you think of your eye as a bath, your dry eye occurs when the bath is ’empty’. This can occur because the ‘tap’ or tear gland does not produce enough tears. One method of improving the surface of the eye (akin to filling the bath) is to put a plug in the tear duct. These are known as punctal plugs and can significantly improve dry eye in cases where lubricants alone are ineffective.
What are punctal plugs?
Punctal plugs are tiny silicone implants that are placed in the tear duct (into the opening or ‘punctum’). They measure between 0.4 and 0.8 mm in diameter and are sized according to the size of your punctum. The plug is transparent and barely noticeable to the naked eye.
How are punctal plugs placed?
The plug is guided into the punctum using a special applicator. This can be done in the clinic room with anaesthetic eye drops and is usually relatively pain free.
The plug is inserted into the punctum of the tear duct to prevent tears escaping down into the nose and should sit tightly.
What are the risks of punctal plugs?
There are very few risks using punctal plugs.
The most common risk is that the plug can fall out of its own accord. This happens intermittently and the plugs can be replaced if required.
The plugs can cause watering of the eye as the tears cannot escape down the tear duct into your nose. This does not usually cause too many problems and in many cases will help the eye fell more comfortable.
Rarely the plugs can irritate the eye.
If the plugs cause any significant problems they can usually be easily removed in clinic.
What is punctal cautery?
Punctal cautery is similar to punctal plugs but is a more permanent solution. Normally Raji will trial you with punctal plugs and if these prove beneficial he will then consider using punctal cautery.
How do you perform punctal cautery?
Punctal cautery is normally performed in the minor procedures room. The procedure involves a small injection of local anaesthetic into the eyelid. A probe is placed into the tear duct which cauterises the inner aspect of the tear duct to cause a scar and ‘seal up’ the tear duct.
What are the risks of punctal cautery?
There are very few risks with punctal cautery:
You may have a bruise after the treatment involving the eyelid. This will normally resolve in the first week or two.
There is a small risk of developing a watery eye after treatment. This usually depends on whether the both the upper and lower tear ducts are cauterised or simply the lower ducts.
Rarely the tear duct can re-open after the cautery has been performed. If this is the case Raji would normally advise that the cautery is repeated. If this still proves ineffective then Raji will discuss further surgical options with you in clinic.
BEB is found in approximately 5 per 100,000 population and is more commonly found in females. Most patients are over the age of 60 years.
The cause of BEB is poorly understood and is felt to be secondary to a dysfunction in the ‘circuit regulation’ of nerves providing ocular sensation and movement of the eyelid.
BEB is associated with dry eye and symptoms can be increased in certain situations including wind, pollution and stress.
Common symptoms include:
Ocular discomfort in bright lights (photophobia)
Increased blink rates
Twitching or involuntary movements of the eyelids. This may start on one side of the face and spread to both sides with time.
Dry eye symptoms (grittiness and redness of the eyes)
Spasm of the eyebrow
WHAT CAN IMPROVE BLEPHAROSPASM?
Certain actions can improve BEB which can aid in the diagnosis. These include sleep, reduction in stress, occlusion of vision of the affected eye, ocular lubricants, talking and humming.
WHAT ARE THE TREATMENTS FOR BEB?
No cure currently exists for BEB and treatments are mainly aimed at alleviating symptoms.
Conservative measures include:
Ocular lubrication
Tinted lenses on spectacles (FL-41 tints)
Eyelid hygiene
Medical treatments
The mainstay of treatment is the application of Botulinum A toxin. This is otherwise known as Botox® or Dysport®. Botulinum A Toxin provides temporary reduction in the eyelid spasm and has good success rates. The toxin is produced by a bacteria (Clostridium botulinum) and causes paralysis of muscle by blocking the neural input to muscle.
Botulinum A toxin is applied using injections around the eyelids in clinic. Depending on the manufacturer the treatment will take between 2-7 days to take effect and may provide symptomatic relief last for 2-3 months at which point repeat injections are applied. In some cases the effects may last for more or less time.
Surgical treatments
In cases of BEB associated with dry eye, surgery may be aimed at improving the ocular surface. Minor procedures including occlusion of the tear duct may help to reduce dry eye and BEB.
In severe cases whereby BEB is not responsive to medical treatment more radical surgery may be indicated. This includes surgery to excise the muscle that causes the eyelid to close (orbiculectomy).
Droopy Eyelid (Ptosis)
What is a ptosis?
Drooping of the upper eyelid is a known as a ptosis. Occasionally the eyelid can affect the vision or simply look asymmetric when compared to the other side. In some cases the ptosis is present at birth (congenital ptosis) or may occur due to a condition affecting the muscle (such a myaesthenia gravis or mitochondrial disease). In both cases the ptosis surgery is more complex than a standard ptosis repair and may require a ‘brow suspension’.
In children the reason to operate would be to allow the vision to develop normally in cases where the eyelid impairs sight. One sign that the eyelid may be affecting the sight is if your child is lifts up their chin to see.
What is the treatment?
A brow suspension uses the eyebrow / forehead muscle (frontalis muscle) to lift the eyelid rather than the normal eyelid muscle (levator muscle).
For adults, we normally perform the surgery under a local anaesthetic which is given in the operating room. Occasionally we can give sedation at the same time if you are uncomfortable about having a local anaesthetic on its own.
In children we would perform the surgery under a general anaesthetic.
The surgery usually involves making a small incision on the front of the eyelid with 3 further small incisions just above the eyebrow and in the forehead.
We then pass a sling through these incisions to form a pentagon. This pentagon connects the forehead muscle (frontalis) to the eyelid. Raji will often use silicone as the sling material, but other materials can be used including tissue harvested from your thigh (fascia lata). Raji will discuss with you the various options.
The wounds are sutured and in children we use dissolvable sutures. The surgery normally takes about 45 minutes per eyelid but can sometimes take longer.
After surgery the eyelid can then be lifted by raising the eyebrow, this can take some time to work normally particularly in children.
What are the risks of surgery?
For parents it is important to know that when your child first wakes up the operated eye will not close very well. This can take a few hours to improve and in some cases a couple of days until closure is near full. Normally we would not expect the operated eyelid to lower symmetrically with the other side when looking down (known as lid lag). This is a common side effect of the surgery and to be expected.
The risks of surgery include postoperative bleeding, scarring to the eyelids, exposure of the eye and infection. We advise that you use an antibiotic ointment in combination with a lubricant after the surgery to help reduce the risk of infection. Raji will usually also prescribe an oral antibiotic.
Occasionally we may under or over correct the position of the eyelid. Most of these complications can be corrected if required with a second operation.
The most serious risk of any eyelid surgery performed is damage to your eyesight. Fortunately this risk is extremely rare.
What happens on the day of surgery?
On the day of surgery you will be told a time and place to come in to the hospital. You will be met by the nursing team and one of the surgical team will also see you.
If you are for day case surgery you will need to make sure that someone can be with you on the evening of surgery. If you are coming to stay the night you will need to bring some overnight clothes and toiletries for the duration of you stay. We advise that you also bring in your medications with you when you come into hospital.
What can I expect after surgery?
The eyelids will be bruised after surgery and you may have some blood stained tears which is quite normal initially.
The eyelid will often look a little swollen for the first couple of weeks. In addition you may find it difficult to fully close the eyes over the first couple of days. This settles down as the eyelid relaxes into its normal position.
What do I need to do after surgery?
Normally we ask that you keep the wounds around your eye clean after surgery. You can clean the wound by allowing boiled water to cool and gently dabbing the wounds with a cotton bud.
We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection and to help lubricate the eyes for two weeks. In addition you will have a lubricant ointment (lacrilube or viscotears) to help protect the eye. Lastly you will have a short course of oral antibiotic to further prevent infection.
We normally advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.
We will see you in the first week after surgery and then 2-3 weeks later.
You should avoid any strenuous activity including lifting heavy objects for at least two weeks and avoid swimming for three weeks after surgery.
Syringe and Probe of Tear Duct
Raji is happy to see children with blocked tear ducts. This will usually manifest as a constantly watery and discharging eye from birth.
Removal of Eyelid or Eyesocket lesions
Raji performs surgery for children relating to eyelid and eye socket lesions. This is includes chalazions, dermoid cysts and other lesions seen in children.
Discussion with Raji is important to answer any questions that you may have. For information about any additional treatments that are not featured within the site, please contact us for more information.
