Dr. Katherine Lane , M.D.

University of Vermont Medical Center

Drainage of Blocked Tear Ducts (Adults and Children), Ptosis, Thyroid Eye Disease, Eyelid and Orbital Tumors.

Dacryocystorhinostomy (drainage of blocked tear ducts) is a surgery done to create a new drainage opening from the blocked sac directly into the nose to bypass the obstruction in the nasolacrimal duct. In children with blocked tear ducts, surgery is done by opening the blockage by inserting a thin metal probe through the punctum and down the nasolacrimal duct into the nose. Blocked tear ducts can prohibit tears from properly draining causing the eye to remain watery and iritated, it can cause reaccurent eye infections and inflammation, and blurred vision. 

Ptosis surgery usually involves tightening the levator muscle in order to elevate the eyelid to the desired position. If the levator muscle is extremely weak, then a “sling” operation may be performed, enabling the forehead muscles to elevate the eyelid(s). Ptosis left untreated can cause blocked vision, an astigmatism, or develop eye disease. 

 Thyroid Eye Disease surgery is categorized in three different stages. Stage one of surgery is orbital decompression (removing part of the bony orbit and fat behind the eye to relieve pressure in the eye socket). This can prevent damage to the optic nerve and allow the eye to move back into a more normal position in the eye socket. Stage two is eye muscle surgery to correct misalignment of the eyes and double vision. Stage three is eyelid surgery to adjust the position of retracted lids in order to improve eyelid closure and restore eyelid function. Removal of excessive fat from the eyelids can also improve their appearance.

Surgical excision is the most effective treatment for periocular skin cancers. Complete removal of the skin cancer is necessary to reduce the chance of recurrence. Reconstruction of the resulting defect is tailored to preserve eyelid function, protect the eye, and provide a satisfactory cosmetic appearance.