PEDIATRIC & CONGENITAL CONDITIONS
Oculofacial plastic surgeons specialize in the treatment of all pediatric and congenital eyelid, eye socket, and tear duct disorders. The most common include:
CONGENITAL PTOSIS
Children are sometimes born with drooping upper eyelids. Most commonly, there is a problem with the muscle that raises the eyelid. If the eyelid(s) droop enough that they cover the pupil, they can block vision. Since children’s visual system is still developing at young ages, ptosis can result in permanent blindness (amblyopia). If congenital ptosis is affecting vision, ptosis repair surgery should be sought as soon as possible. Since the cause of ptosis in children is hindered by the fatty deposits in the muscle, the approach for ptosis repair in children often differs from the approach for adult patients. A silicone tubing system is used to leverage the strong lifting of the forehead muscles to assist with poor functioning eyelids.
CONGENITAL TEAR DUCT OBSTRUCTION
A tear duct obstruction in infants may present as constant tearing, discharge, or even an infection of the tear duct (dacryocystitis). Unlike in adults, tear duct obstruction is usually due to a membrane that blocks the outflow of tears into the nose. This often resolves spontaneously as your child grows. Massage and warm compresses may be enough to alleviate symptoms. If the symptoms continue past one year of age, probing the tear duct under anesthesia is usually effective as resolving the issue. Probing is a non-invasive, 15 minute procedure performed in the operating room.
EPIBLEPHARON
This is a common condition in children of Asian descent. The skin and muscle in the lower eyelid override the eyelid margin, causing the lashes to turn in and scratch the eye. As children age, this problem may spontaneously resolve, however surgical correction is sometimes necessary, especially if there are signs of corneal damage.
ORBIT DISEASE
Orbital (eye socket) disease is uncommon in children, but it does occur. Infections in the orbit are called orbital cellulitis. This is often the result of spreading inflammation from the sinuses. If untreated, it can cause blindness and even be life-threatening. Intravenous antibiotics must be administered immediately to treat this condition.
ORBITAL TUMORS
Orbital tumors occur rarely, and when they do, they are most often benign. Vascular malformations are the most common growths. Sometimes called strawberry or capillary hemangiomas, they are lumpy, red, and may be seen on the eyelids or even extend into the eye socket. They often spontaneously resolve between the ages of six to eight. If the growth is blocking vision, it can be treated with medications (propranolol) and only rarely requires surgery.
RECOVERY FROM PEDIATRIC & CONGENITAL CONDITIONS
Most patients only experience mild discomfort after treatment of pediatric and congenital conditions, as many of the recommended solutions are non-surgical or minimally invasive. Tylenol is recommended to ease the discomfort, which should subside within a few days. Arnica and Bromelain are recommended to take prior as well as after surgery to minimize the bruising and swelling of the face.
Cold compresses can help young patients through the healing period, and we may prescribe antibiotic ointment and/or eye drops.
Dr. Kashyap sees children for a follow-up visit seven to 10 days after surgical treatment to provide post-operative care. Parents are advised to ensure children do not disturb the treatment site by rubbing their eyes or physically exerting themselves during play; rest is important during the healing period.
If children experience dry eye after surgery, we can recommend artificial tears to keep eyes lubricated and ensure kids are comfortable.
