SINGAPORE: Have you ever seen anyone with bulging eyes? Or noticed someone with droopy eyelids? Many eye conditions affect your sight, but there are some that also affect your looks.

Some patients suffering from thyroid disease may have an eye disease that causes them to have a “staring” appearance or protrusion of the eye. For this reason, this condition is sometimes referred to as “big eye” disease. Although this rarely results in permanent loss of vision, appearance-wise, it can draw much unwanted attention and unkind comments.

Likewise for patients suffering from ptosis, a droopiness of the upper eyelid, which may be present at birth or can happen later in life. These patients are often self-conscious about how they look. They may also find it more and more difficult to keep their eyes open or may feel eye strain, and their brow area may ache from the increasing efforts to raise their eyelids to see properly.

Availability of treatment:

Not too ago, it was thought that one had to live with these conditions and appearance no matter how much they interfered with one’s daily routines. However, treatment is now available to help improve one’s appearance and sense of well-being, and this may be done by eye specialists who are also trained as plastic and re-constructive surgeons.

The Oculoplastic Service at the Singapore National Eye Centre (SNEC) treats problems that interfere with the normal function of the eye. Often, this may include re-constructive surgery to the eye due to trauma and other reasons.

Oculoplastic surgery may not necessarily be performed directly on the eye but on the structures and various tissues that make up part of the eye and surrounding areas. This may come in the form of an eye lift that is surgery carried out to the eye lids, repair of fractures to the orbit, or removal of obstruction near or in the tear ducts.

Some of these treatments are just for visual appearance (cosmetic surgeries) while others are carried out for medical reasons. Worldwide, more people are turning to these procedures as they age. With this in mind, the Aesthetic Eyeplastic Service at the SNEC was set up to cater to this demand from patients.

The SNEC attends to 250,000 outpatient visits and performs 27,000 major eye surgeries and laser procedures every year, out of which are 800 oculoplastic procedures. A strict quality assurance programme instituted by the centre ensures excellent results, comparable to other world-class eye institutions.

The team of Oculoplastic and Aesthetic Eyeplastic consultants received post-graduate specialist training in North America, the UK and Australia. They are committed to ensuring cost-effective treatment options and the best outcomes possible for patients.

They are also committed to research, particularly in the area of thyroid eye disease. Currently, the team is carrying out a trial to compare the effectiveness of two different drug treatments for patients suffering from this disease. This trial, supported by the Biomedical Research Council in Singapore, will allow doctors to learn more about the treatment for this complex disorder.

Common procedures:

These are some of the common procedures done on patients seeking treatment:

Eye lift:

A cosmetic surgery that is carried out to reduce eyelid drooping, which can give the impression of being constantly tired and make a person appear older. The surgeon makes incisions at the crease of the upper and lower eyelids, while a patient is under local anaesthesia. The surgeon removes excess skin and fatty deposits before sewing stitches in where the incisions were made. There is scarring due to the surgery, but because the incisions are made in the crease of the eyelids they cannot be seen once the incision has healed.

Repair of orbital fractures: The orbit, which is the bone in which the eye sits, is actually part of the skull. When a fracture occurs, an orbital surgery involves having micro or mini plates surgically screwed to the orbit structure to hold the fractured bone in place, while the body’s natural defences repair the damage. Sometimes, this procedure is needed when there are orbital tumours growing around the eye, as tumours grown to a certain size can impact the orbit causing fractures, and surgery can help the orbital fractures repair but may not necessarily help the tumours.

Removal of obstruction in tear ducts: The tear ducts provide tears, a watery solution created by the body to keep the eyes clean and stop them from drying out.

Sometimes, as a result of infection, injury or abnormal growth within the tear duct system, they become blocked and can cause excessive tearing.

Surgery is necessary to treat those with severe obstruction of the tear ducts, or those who have repeated infections of the tear duct system. This procedure creates a new channel to allow tears to drain into the nose again.

Singapore National Eye Centre is an institution of SingHealth, the largest integrated healthcare group in Singapore.