Trauma and Oculoplasty Services
Ocular Trauma is one of the most under- recognised causes of preventable blindness world-wide and 90% of these cases occur in developing countries. Ocular trauma mainly occurs in young population, children and active adults, who are the present and future pillars of the society. Ocular trauma, if properly managed at primary, secondary and tertiary level, the resulting blindness is preventable to a large extent.
Common causes of ocular trauma are road traffic accidents, play area injuries in children and occupational injuries. Many times the first help an injured patient seeks is of the general practitioner or family doctor and not of the ophthalmic specialist. So it is important for all to know few basic principles of primary management.
- Do not force the eye open to see what is wrong.
- Do not put any eye drops or eye ointment or home made remedy in the eye.
- Wash the eye only in case of chemical injury. Not in any other trauma.
- Patch the eye with a clean cloth without applying pressure if there is bleeding.
- If general practitioner sees patient first, a sterile dressing should be applied. A broad spectrum antibiotic and pain killer should be started. A booster dose of Tetanus toxoid vaccination should be given if patient has not received it in recent years.
- Attempt should not be made to remove any foreign body embedded in the cornea. Patient should be advised to be nil by mouth and referred to an ophthalmologist immediately along with responsible attendant.
We, at Bapaye Eye Hospital are equipped to manage all kinds of ocular trauma.
Lacerations of eye lids, though seemingly small are meticulously sutures under microscope as improper apposition can cause disfigurement and permanent watering. If injury involves the tear duct, we place a stent to preserve its patency.
Penetrating injuries to the front portion of the eye (cornea and sclera) are similarly sutured by microscopic surgery. The suture material that we use is very fine and gives minimal pain and best possible visual results. Dr. Bapaye eye hospital has special expertise in managing even difficult tears which run under the ocular muscles to the back of the eye.
Trauma to the lens needs it’s removal and replacement by an artificial lens. Many a times the scar induced by the injury causes high astigmatism (cylindrical power), but we have even implanted toric lenses in such cases, which not only restores vision, but also negates the induced cylindrical power. If the support for placing artificial lens is also damaged, we have techniques to stitch the lens in the eye and even better, stick it using an imported fibrin glue, by a sutureless (no stitch) technique.
Traumatic cataract in a patient with previously sutured corneal tear
Post op vision 6/6 in another patient with corneal tear and traumatic cataract implanted with Toric IOL
Our vitreo-retina department has the expertise to manage devastating retinal injuries and intra ocular foreign bodies. Dr. Maneesh Bapaye has salvaged hundreds of eyes by removing foreign bodies from inside the eye. If the foreign body is metallic, a magnet can be used. Removing large non magnetic foreign bodies used to be a problem. Dr. Maneesh devised an instrument called “Claw forceps”, which revolutionised this surgery and got him international acclaim. His instrument was used to remove pellets in the eye after the Kashmir riots and his instrument is a part of the armamentarium of retinal surgeons world over.
Dr. Bapaye hospital is open 24/7 for any ocular emergencies and is a tertiary referral centre for management of ocular trauma for North Maharashtra.
We have managed to restore even 20/20 vision to many patients whose eyes had been torn in accidents.
Removal of large intra ocular foreign body with The Claw Forceps
Specialised techniques of Trauma repair
Before and after repair of lid tear with canalicular tear secondary to dog bite
Oculoplasty
Our oculoplasty services include:
- Endonasal DCR: For naso lacrimal duct blocks
- Lid Surgeries for conditions like ptosis, ectropion, entropion, lagophthalmos.
- Cosmetic rehabilitation for painful blind eyes: Evisceration/ Enucleation followed by customised artificial eye prosthesis
- Botulinum toxin injection for Blepharospasm and Hemifacial spasm
Good cosmetic outcome after Ptosis correction
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