By Tristan Reuser, Oculoplastics Consultant at Midland Eye
Although most people associate plastic surgery with improving appearance, eye plastic surgery—also known as oculoplastic surgery—is a specialised field focusing on the intricate structures surrounding our eyes. This branch of ophthalmology addresses both functional and aesthetic concerns, playing a crucial role in maintaining eye health and improving quality of life for many individuals.
Understanding Eye Plastic Surgery
Oculoplastic surgery encompasses procedures involving the eyelids, tear ducts, orbit (eye socket), and the surrounding facial structures. It’s important to note that these surgeries do not involve the eyeball itself. Instead, they focus on the supportive structures that are vital for proper eye function and facial aesthetics.
Eye plastic surgery can treat a wide range of conditions, which can be broadly categorised into trauma cases, medical issues affecting vision, and cosmetic concerns.
Trauma Cases
Trauma to the eye area can result in severe injuries requiring immediate attention. These traumatic incidents commonly include falls resulting in facial injuries, foreign object injuries (such as children accidentally poking themselves with pencils), violent assaults, and animal bites, particularly dog bites.
Oculoplastic surgeons often work alongside emergency room physicians to provide specialised care in these situations, aiming to restore both function and appearance.
Medical Issues Affecting Vision
Many eye plastic surgery procedures address medical conditions that can significantly impact vision and eye health. Here are a few of the more common medical issues that can be addressed with eye plastic surgery:
Ptosis: This condition, characterised by drooping upper eyelids, can obstruct vision if severe. Ptosis repair surgery can lift the eyelid to its proper position, improving both vision and appearance.
Thyroid Eye Disease: Associated with thyroid disorders, this condition can cause bulging eyes (proptosis), eyelid retraction, and double vision. It’s more common in women than men and can significantly affect quality of life. If caught early, it can be prevented, but late-stage cases may require extensive surgery. Orbital decompression (removing some of the bone from around the eye socket) can alleviate symptoms and protect vision. Double vision can be addressed with surgery to the eye muscles. Starry eyes, due to bulging, may also need corrective surgery.
Ectropion and Entropion: These conditions involve the eyelid turning outward (ectropion) or inward (entropion), leading to irritation, tearing, and potential corneal damage. Ectropion can cause runny eyes, while entropion may lead to a scratchy sensation and even vision loss if left untreated. Surgical correction can restore proper eyelid position and protect the eye.
Tear Duct Disorders: Blocked tear ducts can cause excessive tearing and increase the risk of infection. This can be due to various factors, including ectropion (where the tear duct doesn’t sit flush on the eyeball) or blockages within the tear duct itself. Procedures like dacryocystorhinostomy (DCR) can create a functional pathway from the tear duct to the nose, restoring proper tear drainage. In some cases, blockages can lead to dacryocystitis, an infection of the tear sac, which may require treatment under general anaesthesia.
Many of these medically necessary procedures are covered by the NHS, subject to specific criteria and local funding policies. However, it’s worth noting that coverage can vary depending on your local Integrated Care Board’s policies. Some areas, for instance, may not fund treatment for ectropion or certain cosmetic issues.
Patients experiencing vision problems or suspicious growths should consult their GP or optician for a potential referral to an oculoplastic specialist or get in touch with a specialised eye clinic directly for a consultation.
Cosmetic Concerns
While not medically necessary, cosmetic eye procedures can significantly impact self-esteem and perceived quality of life:
Blepharoplasty: Often called an “eye lift,” this procedure removes excess skin and fat from the eyelids, creating a more refreshed and youthful appearance. In some cases, upper eyelid blepharoplasty may be covered by the NHS if excess skin significantly impairs vision.
Under-eye Rejuvenation: Various techniques, including fat repositioning or filler injections, can address under-eye hollows and dark circles.
Eyebrow Lifts: This procedure can restore a more alert and youthful appearance to the upper face.
It’s important to note that purely cosmetic procedures are not typically covered by the NHS. However, many clinics offer financing options to make these treatments more accessible, and some may be available via private health insurance.
The Eye Plastic Surgery Process
The journey typically begins with a comprehensive consultation. During this appointment, the surgeon will examine the patient’s eyes and surrounding structures, discuss their concerns, and explain potential treatment options. At many clinics, including Midland Eye, the initial consultation fee is around £230 for medical issues, or £100 for cosmetic procedures (which is deducted from the total procedure cost if you decide to go ahead).
If surgery is recommended, patients receive detailed information about the procedure, including potential risks and expected outcomes.
For cosmetic procedures, there’s typically a two-week cooling-off period to allow patients time to consider their options or seek a second opinion.
Many eye plastic surgeries can be performed under local anaesthesia, allowing patients to return home the same day. This approach is often preferred as it requires less recovery time and carries fewer risks than general anaesthesia.
Recovery times vary depending on the specific procedure. With any eye plastic surgery, some bruising and swelling is expected due to the sensitivity of the tissue around the eye. Depending on your profession, most patients can resume normal activities within one to two weeks, though complete healing may take several months. Surgeons provide detailed aftercare instructions to ensure optimal results and minimise complications.
Your eye clinic will usually conduct a review consultation, depending on the condition, to check the result of the surgery and whether it successfully solved your issue. This is increasingly being done via telemedicine platforms, such as video consultations or uploading photos, allowing much greater flexibility for patients. At Midland Eye Clinic, we also offer a free top-up surgery in the rare instance that patients aren’t completely satisfied with the result.
Sometimes, it is necessary to perform further surgeries to solve issues and rule out underlying problems.
Considerations
As with any surgical procedure, eye plastic surgery carries some risks. These may include temporary bruising and swelling, dry eyes, and in rare cases, infection or changes in vision. However, serious complications are uncommon when procedures are performed by qualified, experienced oculoplastic surgeons.
Waiting times for eye plastic surgery can vary significantly depending on whether you’re pursuing treatment through the NHS or privately. NHS waiting times can range from a few weeks to several months, depending on the urgency of your condition and local resources. Private treatment typically offers shorter waiting times, with many clinics able to schedule procedures within a few weeks.
Costs for private treatments vary depending on the specific procedure. As a general guide, treatment for small lumps and bumps might cost around £500, while more complex procedures like correcting drooping eyelids could be in the region of £2,500. Many clinics offer detailed pricing information on their websites or during the initial consultation.
Whether considering eye plastic surgery for medical reasons or to refresh one’s appearance, it’s a decision that requires careful consideration. With the guidance of a skilled oculoplastic surgeon, patients can make informed choices that may significantly improve their vision, appearance, and overall quality of life.
If you suffer from an eye condition, it’s always best to consult your GP or a specialised eye clinic to ensure it isn’t the result of a more serious underlying condition. Even if the issue is purely cosmetic, that doesn’t mean you need to suffer. Eye plastic surgery provides the care you need to maintain healthy, functional, and confident eyes throughout your life.
ABOUT THE AUTHOR
Tristan Reuser is an Oculoplastics Consultant at Midland Eye. Midland Eye was founded by four ophthalmic surgeons who wanted to provide patients with a comprehensive, specialist service for the diagnosis and treatment of all eye conditions. The team are leaders in their field and offer a consultant-only service to all patients requiring eye care or surgery. Every consultant is qualified to treat common eye conditions such as cataracts but each one also has a particular area of specialisation, ensuring that patients get the best possible outcome, no matter what the diagnosis. Private patients can benefit from access to collaborative care and facilities with the latest and best technology. The clinic’s approach is designed to be convenient for people who lead busy lives and have limited time to seek medical advice and treatment.
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