What is Ophthalmic Plastic surgery?

“It’s better to do a dull thing with style than a dangerous thing without it.”- Charles Bukowski

What is Ophthalmic plastic surgery or Oculoplasty? I often get asked this question when I tell them what I'm specializing in. Most people are not aware that such a speciality exists  including majority of medical doctors. They ask me how can you be an Ophthalmologist and a Plastic surgeon at the same time. It's a tedious exercise explaining it to people what my work comprises and one which makes my wife make fun of me when I explain because she's heard it so many times. I thought it would make sense to pen it down. Here it goes....

Ophthalmic Plastic Surgery is a subspecialty of Ophthalmology which deals with the orbit (eye socket), eyelids, tear ducts, and the face. It also deals with the reconstruction of the eyelid, the eye socket, and surrounding structures. Lately as a natural progression this branch has been getting into Facial Aesthetics in a big way in the form of Brow lifts, facelifts,Botox, fillers and Facial Rejuvenation.

The subspecialty of ophthalmic plastic surgery was born in the mid-twentieth century in the United States at the conclusion of World War II. The art of oculoplastic surgery, however, is centuries old, bearing its roots in antiquity in India,the Far East, and Europe.

The various procedures that have evolved over centuries can be divided into several general categories: reconstructive, restorative,and cosmetic.  Oculoplastic surgeons have perfected, refined, and pioneered new techniques of lacrimal surgery, ptosis repair and blepharoplasty, orbital surgery, lid malpositions, and flaps and grafts. With the close relationship of this speciality with Eye Cancer and eye reconstruction after removal of tumours,  Oculoplastic surgeons are de-facto Ocular oncologists. Since the treatment of the above conditions often requires multidisiplinary approach the possibilities of this field are endless. It also requires good working relationship with other specialties and to create a valuable team to treat the patients.

Oculoplastic surgery became recognized as a unique subspecialty of ophthalmology at the end of World War II. Numerous orbital and periocular injuries were treated by general ophthalmologists without prior training or exposure to ophthalmic plastic surgery. More often than not, trial and error were keys in developing these procedures. Among the earliest pioneers was Dr. John M. Wheeler who established a full practice based on oculoplastic surgery. He is known as the father of oculoplastic surgery. His student Wendel Hughes was the next major force in this field. Further Hughes' students Alston Callahan,Byron Smith and Crowell Beard propagated this field across the world. This group of Oculoplastic surgeons went on to found the American Society Ophthalmic Plastic and Reconstructive Surgeons(ASOPRS) in 1969. This was the first such society in the world for oculoplastic surgeons. Later more such societies got formed in other parts of the world. Europe (ESOPRS), Canada (CSOPRS), Asia-Pacific (APSOPRS) and even India (OPAI).

It is a relatively less known specialty. ( I myself did not know about it till I joined residency). There lies the challenge in this field and also the greatest opportunity to grow. The specialists in this field are there in it only for passion since the other sub-specialities in Ophthalmology are much more rewarding monetarily. This sub-speciality is quite hard to master yet it is incredibly satisfying. I am honoured and privileged to count myself among these stalwarts. Like I said the possibilities are endless and there is so much work to be done....

References:
1. Smith and Nesi's Ophthalmic Plastic and Reconstructive Surgery
2. Local Flaps in Facial Reconstruction by Shan R. Baker and Neil A. Swanson