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Oculoplastic surgery is a field within ophthalmology focused on the surgical and medical management of conditions affecting the eyelids, orbits, and surrounding facial structures. This branch of surgery combines aesthetic and reconstructive techniques to enhance both function and appearance.
Whether addressing congenital abnormalities, trauma, age-related changes, or disease, oculoplastic procedures can significantly improve quality of life and vision.
From upper eyelid skin reduction like blepharoplasty to the management of complex conditions such as thyroid eye disease, our range of treatments aims to restore both form and function. On this page, we will explore various oculoplastic treatments, highlighting their purpose and what you can expect during the process. Your eyes deserve the best care, and we are here to help you achieve optimal results.
As we age, the skin around our eyes loses its elasticity and our eyelids become droopy. These changes can impact on both appearance and function, causing discomfort, self-consciousness, and most importantly vision issues. The eyes may look tired, hooded, or heavy. Contributing factors include aging, sun exposure, and genetics. Although symptoms and concerns vary, addressing these changes can enhance both aesthetic and functional outcomes.
This procedure can alleviate vision problems caused by drooping lids and create a more youthful look. It involves discreet incisions for minimal scarring: in the upper eyelid, skin and fat are removed through the natural crease.
Brow lift surgery may be performed in conjunction with blepharoplasty if drooping eyebrows also contribute to the appearance. The surgical approach depends on the severity of brow drooping.
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Surgical intervention carries risks such as bleeding and infection, although these are rare. Patients should inform their surgeon if they are on blood thinners, as this may increase the risk of bleeding. Other potential issues include anesthesia-related risks, swelling, scarring, and the possibility of needing further surgery. Minor bruising and swelling are common but typically resolve within one to two weeks. While most patients experience significant improvement and minimal postoperative discomfort, there is always a possibility that additional treatments may be required to achieve the desired outcome. It is important to discuss all potential risks and alternatives with your surgeon before proceeding.
Post-surgery care for eyelid and brow lift procedures generally involves using cold compresses to reduce swelling and bruising, applying antibiotic ointment or drops, and avoiding strenuous activities for several days. Warm compresses may be suggested later to aid in healing. Patients should keep their head elevated to reduce swelling. Pain is typically mild and can be managed with non-aspirin pain relievers. Most patients can resume normal activities within a few days.
1–2 hours
Day Case
3 days to 1 week
1 day
2-6 weeks
Ptosis, or drooping of the upper eyelid, is a condition that can affect one or both eyes. It occurs when the upper eyelid falls, potentially obstructing the upper field of vision. The degree of drooping can range from mild, where the lid partially covers the pupil, to severe, where the lid completely covers the pupil. When ptosis is present from birth, it is referred to as congenital ptosis.
As we age, the tendon attaching the levator muscle to the eyelid can stretch, causing the eyelid to sag. Additionally, ptosis can occur after cataract surgery or be caused by injury to the oculomotor nerve or the tendon connecting the levator muscle to the eyelid.
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Symptoms of ptosis include difficulty keeping the eyes open, eye strain, forehead aches from the effort to raise the eyelids, and fatigue, especially when reading. Some individuals may need to tilt their head back or use a finger to lift the eyelid to see better. In children, ptosis might also lead to reduced vision in one eye (amblyopia or “lazy eye”), strabismus (misalignment of the eyes), or refractive errors such as astigmatism.
Ptosis can sometimes be a sign of more serious conditions such as myasthenia gravis, a disorder where muscles become weak and tire easily, or Horner’s syndrome, a neurological condition affecting one side of the face due to sympathetic nervous system injury.
Surgical intervention for ptosis is often necessary when the condition affects vision or causes significant cosmetic concerns. The primary objectives of ptosis surgery are to lift the upper eyelid to improve vision, enable proper visual development (in children), and create symmetry with the opposite eyelid. The procedure typically involves tightening the levator muscle to elevate the eyelid. Surgeons may make incisions along the natural skin crease of the upper eyelid to minimize scarring. If the levator muscle is extremely weak, a “sling” operation may be used to allow forehead muscles to help lift the eyelid. Congenital ptosis is treated based on its severity and the strength of the levator muscle. It is important to note that achieving a completely normal eyelid position may not always be possible.
Ptosis surgery is usually performed on a day surgery basis with older children and adults often undergoing “twilight” anesthesia. Young children will require general anaesthesia.
As with any surgery, potential risks include bleeding and infection, though these are rare. Patients should inform their surgeon if they are on blood thinners. Minor bruising and swelling are common and usually resolve within one to two weeks. Some patients may experience dry eyes after surgery, which could make contact lens use uncomfortable or require over-the-counter eye drops.
The final position of the eyelid may not be exactly as desired, and touch-up surgery might be needed. While perfect symmetry between the eyelids cannot always be guaranteed, most patients see significant improvement and are satisfied with the results. Discussing all potential risks and expected outcomes with your oculoplastic surgeon is crucial before proceeding with the surgery.
1–2 hours
Day Case
3 days to 1 week
1 day
2-6 weeks
Ectropion is a condition where the lower eyelid turns outward, exposing the eye to the environment. This can occur naturally as a result of the aging process, or it may be caused by previous facial trauma, scarring, paralysis, or surgery.
Ectropion is a treatable condition, and early diagnosis and intervention can help prevent complications. It’s important to discuss all available treatment options with your oculoplastic surgeon to determine the best approach for you.
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Procedure: The specific type of surgery depends on the cause of the ectropion. However, it typically involves tightening the lower eyelid tissue to restore its normal position. In some cases, a skin graft from the upper eyelid or behind the ear may be used to rebuild the eyelid structure.1–2 hours
Day Case
3 days to 1 week
1 day
2-6 weeks
Entropion is a condition characterised by the inward turning of the upper or lower eyelid, causing the eyelashes to rub against the eye. This inward turning can lead to irritation, redness, sensitivity to light and wind, and potentially more serious issues like corneal damage, infections, and vision loss if left untreated. The condition is often caused by age-related weakening of the eyelid muscles or stretching of the tendons. Other causes include scarring from previous surgeries, trauma, or neurological conditions that affect eyelid movement.
The inward-turned eyelid can cause a foreign body sensation, excessive tearing, crusting, and discharge. Over time, these symptoms can lead to acute light sensitivity, eye infections, corneal abrasions, or ulcers. Addressing entropion promptly is crucial to prevent permanent damage to the eye.
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Procedure: The standard treatment for entropion involves surgical tightening of the eyelid and its supporting structures to restore the lid’s proper position. The surgery is typically performed under local anesthesia with sedation and is often done on a day surgery basis. Postoperative care usually includes the use of antibiotic ointment.
Techniques: Various surgical techniques are available, and the choice depends on the surgeon’s preference and the specific characteristics of the entropion.
Eyelid taping: Temporarily taping the eyelid outward can provide relief in mild cases.
Botulinum Toxin Injection: For those who cannot have surgery or have entropion due to forceful eyelid movements or spasms, botulinum toxin injections can be used. These injections help relax the overactive muscles, allowing the eyelid to return to its normal position for several months.
Surgical intervention carries risks such as bleeding and infection, although these are rare. Patients should inform their surgeon if they are on blood thinners, as this may increase the risk of bleeding. Other potential issues include anesthesia-related risks, swelling, scarring, and the possibility of needing further surgery. Minor bruising and swelling are common but typically resolve within one to two weeks. While most patients experience significant improvement and minimal postoperative discomfort, there is always a possibility that additional treatments may be required to achieve the desired outcome. It is important to discuss all potential risks and alternatives with your surgeon before proceeding.
1 hour
Day Case
3 days to 1 week
1 day
2-6 weeks
Tears begin their journey through two small openings known as puncta, located in the inner corners of the upper and lower eyelids. These puncta lead to tiny tubes called canaliculi, which channel tears into the lacrimal sac, situated between the inner corner of the eye and the nose. From there, tears travel through the nasolacrimal duct, passing through the bony structures of the nose and draining into the nasal cavity.
Blinking helps spread tears across the eyes, keeping them moist, and facilitates the drainage of old tears through the puncta, lacrimal sac, and nasolacrimal duct into the nose.
Treatment for blocked tear ducts varies based on the severity and location of the blockage:
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Warm Compresses and Antibiotics: In some cases, applying warm compresses and using antibiotics may alleviate symptoms and manage mild blockages.
Punctoplasty or Stenting: For blockages at the punctum or canaliculus, minor procedures like punctoplasty or stenting can be used to reopen these passageways.
Dacryocystorhinostomy (DCR): If the nasolacrimal duct is obstructed, a DCR is often required. This procedure involves creating a new drainage pathway from the lacrimal sac directly into the nasal cavity to bypass the blocked duct. This surgery is typically performed under local anesthesia with or without sedation, and a temporary silicone stent may be placed to keep the new drainage pathway open during the healing process.
Conjunctiva Dacryocystorhinostomy (CDCR): In cases where there is a complete blockage at the canaliculus, a CDCR may be performed. This involves placing a glass prosthesis (Jones or Gladstone-Putterman tube) to connect the eye’s surface directly to the nasal cavity. Although this method can be effective, managing a glass tube can be challenging for many patients.
Post-surgery, patients might experience minor nosebleeds for a few days, and most recover within a week. Common risks of these procedures include bleeding and infection, though these are rare. Minor bruising and swelling between the eye and nose are expected and typically resolve within one to two weeks.
Scarring or narrowing of the passageways may occur, potentially necessitating further surgery. The success of the procedure cannot be guaranteed, and there is always a possibility that additional treatment may be needed. Discuss all potential risks, benefits, and alternatives with your surgeon to make an informed decision.
1–2 hours
Day Case
3 days to 1 week
1 day
2-4 weeks
Your eyelids play a crucial role in keeping your eyes healthy. They help spread tears to keep your eyes moist, clean the front surface of your eye (the cornea), keep out dust and dirt, and protect your eyes while you sleep. However, if a cancerous tumor grows on your eyelid, it can alter the shape of the lid or affect the surrounding tissue. This can irritate your eye and, if left untreated, could potentially invade deeper structures like your eyeball or eye socket.
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Skin cancer on the eyelids can often be treated with a day case surgery under a twilight anaesthesia. During the procedure, the surgeon will remove the tumor along with a small amount of healthy skin around it (called the margin of clearance). This is important to ensure that no cancer cells remain. The removed skin is then sent to a lab where a pathologist examines it under a microscope to check for any remaining cancer cells.
In some cases, this testing is done immediately at the hospital (called a frozen section). If the results show that no cancer cells are left, the surgeon can proceed with reconstructing your eyelid right away. If cancer cells are found, more skin will be removed until the margins are clear.
After the surgery, you might experience some bruising and swelling around the eyelid. Sometimes, additional procedures may be needed as a secondary procedure (for example two staged complex reconstruction), or for fine tuning the eyelid’s position.
Even after successful surgery, there is a chance that the cancer might return months or even years later. If this happens, you might need further surgery or radiation therapy.
It’s important to discuss all your options and what to expect with your healthcare team to ensure the best outcome for your eye health and appearance.
1–3 hours
Day Case
3 days to 1 week
1 day
2-6 weeks
A chalazion is a swollen lump on the eyelid caused by a blocked oil gland located near the eyelashes. If an eyelid becomes inflamed for any reason, these oil glands can get congested with very thick oil. This thick oil not only flows and functions poorly but can also lead to more inflammation. The patient’s immune system then walls-off or isolates the inflamed oil gland tissue into a nodule, which is called a chalazion.
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The oil glands at the eyelid margin normally help keep the eye surface moist and comfortable by stabilizing the tear film. When these glands malfunction, the eye can feel uncomfortable, dry, irritated, or itchy. Some patients complain of a foreign body sensation in the eye, and some have watery eyes. The eyelashes can also develop flakes that look like dandruff. All these problems can lead to blurry vision.
Bleeding and infection, which are potential risks with any surgical procedure, are uncommon. Be sure to tell your surgeon if you are on blood thinners/fish oil supplement, as they may put you at increased risk for bleeding complications.
10-20 mins
Outpatient or Day Case
1 Day
Next day if padded post-op
3 days – 1 week
Thyroid eye disease is an autoimmune disorder that affects the tissues surrounding the eye. It occurs when the body’s immune system mistakenly attacks its own tissues. In this case, the tissues around the eye are targeted, leading to inflammation, swelling, and bulging of the eye.
While thyroid eye disease and thyroid disease both originate from the immune system attacking healthy tissue, one does not directly cause the other. The immune system can attack both the thyroid gland and the tissues around the eye, and the timing and severity of these two conditions can vary significantly from person to person.
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For many, the discomfort from thyroid eye disease can be treated with topical lubricants, wrap-around tinted glasses, sleeping with eye shields, or elevating the head of the bed at night.
When there is active inflammation, certain medications, including steroids and anti-inflammatory medicines, may be used. Radiation therapy is also sometimes considered.
In some cases, surgical intervention may be necessary to improve the function and appearance of the eyes. This can include: