Skip to content
Oculoplastics

Oculoplastics

Oculoplastics is a subspecialty of ophthalmology dedicated to the diagnosis and treatment of conditions affecting the eyelids, the periocular region and the tear ducts. It combines a functional approach — preserving the protection of the eye and the quality of vision — with a reconstructive and aesthetic approach, treating benign and malignant lesions as well as age-related changes.

Medical or surgical management

In some situations, medical treatment is enough to improve symptoms through local care or a suitable ointment.

Surgical management is often required, whether a simple procedure carried out in the consulting room or an operation in the operating theatre, in order to treat the problem effectively and achieve the best functional and aesthetic outcome.

Oculoplastic procedures aim to restore the function of the periocular structures while respecting the natural balance and harmony of the eye area.

What is a chalazion?

A chalazion is a chronic inflammation of a meibomian gland within the eyelid. It appears as a small lump, of variable size, sometimes tender at first and later painless. When it persists despite medical treatment (warm compresses, massage, antibiotic and anti-inflammatory ointment), surgery may be indicated.

What does the procedure involve?

The procedure consists of draining the chalazion through the inner surface of the eyelid in order to evacuate its inflammatory content. In most cases no visible scar is left on the skin.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia (LA)
  • Discharge the same day, after a dressing is applied over the operated eye

After the procedure

  • No contact lens wear for 1 week
  • No swimming pool or sauna for 1 week
  • No sport for 48 hours, no vigorous or contact sport for 1 week; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 7th postoperative day

What is it?

The eyelids may develop various benign lesions, such as:

  • Cysts
  • Papillomas
  • Naevi (moles)
  • Seborrhoeic keratoses
  • Xanthelasmas
  • Other small skin growths

Even when benign, these lesions can cause aesthetic concern, irritation or a gradual increase in size. A specialist examination confirms their benign nature and allows the most appropriate treatment to be proposed.

What does the procedure involve?

The procedure consists of removing the lesion while preserving as much healthy tissue as possible, in order to achieve an optimal functional and aesthetic result. Depending on its nature, the lesion may be sent for histopathological analysis.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia (LA)
  • Discharge the same day, after a dressing is applied over the operated eye

After the procedure

  • No contact lens wear for 1 week
  • No swimming pool or sauna for 1 week
  • No sport for 48 hours, no vigorous or contact sport for 1 week; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 7th postoperative day

What are malignant eyelid lesions?

The eyelids can be the site of malignant skin tumours. The most common are basal cell carcinoma, squamous cell carcinoma and, more rarely, sebaceous carcinoma or melanoma.

These lesions usually appear as a small wound that does not heal, a nodule, a persistent crust or a gradual change in the skin of the eyelid. They may sometimes cause loss of eyelashes, bleeding or chronic irritation.

Early diagnosis is essential to allow effective and complete treatment while preserving eyelid function and the appearance of the eyes as far as possible.

What does the procedure involve?

Treatment relies on complete surgical excision of the tumour, with safety margins adapted to its type and extent. The aim is to achieve a complete cure while preserving the best possible eyelid function.

Once the tumour has been removed, reconstruction of the eyelid is often carried out during the same operation. The technique depends on the size, location and depth of the lesion: direct closure, a local flap or a skin graft, in order to achieve the best functional and aesthetic result.

The surgical specimen is systematically sent for histopathological analysis, to confirm the diagnosis and verify that the excision is complete.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia (LA) or local anaesthesia with sedation, depending on the extent of the lesion and the type of reconstruction
  • Discharge the same day, after a dressing is applied over the operated eye
  • You are advised to be accompanied on the way home

After the procedure

  • Sutures removed between the 7th and the 15th postoperative day
  • No contact lens wear for 10 days
  • No swimming pool or sauna for 15 days
  • No sport for 10 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 15th postoperative day

Regular follow-up is recommended after treatment, in order to monitor healing, detect any recurrence and look for the appearance of new skin lesions.

What is dermatochalasis?

Dermatochalasis is an excess of eyelid skin, most often related to the natural ageing process. This excess skin can cause a feeling of heavy eyelids, aesthetic concern and, in some cases, reduce the upper visual field.

What does blepharoplasty involve?

Blepharoplasty is a surgical procedure designed to correct the excess skin of the eyelids. Depending on requirements, it may also be combined with reduction or repositioning of the fatty tissue.

The aim is to open up the gaze, improve visual comfort and preserve a natural, harmonious result.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia with sedation
  • Discharge the same day, after a dressing is applied over the operated eye
  • You are advised to be accompanied on the way home

After the procedure

  • Sutures removed between the 7th and the 15th postoperative day
  • No contact lens wear for 10 days
  • No swimming pool or sauna for 15 days
  • No sport for 10 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 15th postoperative day

What is ptosis?

Ptosis is an abnormal drooping of the upper eyelid. It can affect one or both eyes and lead to a reduced visual field, visual fatigue or the need to constantly raise the eyebrows in order to see better. The causes of a drooping eyelid are many, and the surgical procedure depends on the cause of the ptosis.

What does the procedure involve?

The procedure consists of tightening or shortening the eyelid levator muscle, in order to restore a normal eyelid height and improve visual function.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia with sedation
  • Discharge the same day, after a dressing is applied over the operated eye
  • You are advised to be accompanied on the way home

After the procedure

  • Sutures removed between the 7th and the 15th postoperative day
  • No contact lens wear for 10 days
  • No swimming pool or sauna for 15 days
  • No sport for 10 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 15th postoperative day

What are entropion and ectropion?

Entropion is an inward turning of the eyelid. The eyelashes then rub against the eye and cause irritation, pain and watering, as well as a risk of injury and infection of the cornea.

Ectropion is a malposition in which the eyelid margin turns outwards, leaving the eye poorly protected. This eversion can cause chronic inflammation of the tarsal conjunctiva, as well as chronic watering and irritation of the ocular surface.

These conditions are most often related to ageing, but may also have other causes.

What does the procedure involve?

Surgery restores the eyelid to its normal position by tightening the loosened tissues and correcting the structures responsible for the malposition.

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia with sedation
  • Discharge the same day, after a dressing is applied over the operated eye
  • You are advised to be accompanied on the way home

After the procedure

  • Sutures removed between the 7th and the 15th postoperative day
  • No contact lens wear for 10 days
  • No swimming pool or sauna for 15 days
  • No sport for 10 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 15th postoperative day

What is it?

The tear ducts drain tears from the surface of the eye into the nasal cavity. When they are narrowed or blocked, tears can no longer drain normally. They then accumulate on the surface of the eye and may give rise to various symptoms and complications, in particular:

  • Chronic watering (epiphora)
  • Infections of the lacrimal sac (dacryocystitis)
  • Persistent irritation of the eye and eyelids

Chronic watering is a very common reason for consultation. Although it is generally not a sign of a serious condition, it can have a significant impact on quality of life.

Having to wipe the eyes repeatedly can become particularly troublesome day to day, especially when reading, driving, at work or during social interactions.

The constant flow of tears also encourages irritation of the skin of the eyelids and cheek, which often becomes red, tender and fragile as a result of chronic moisture.

Finally, an excess of tears on the surface of the eye can affect the quality of vision: by altering the stability of the tear film, it causes blurred or fluctuating vision.

A specialist assessment locates the obstruction and determines the most appropriate treatment.

What does the procedure involve?

Surgical treatment depends on the cause and the location of the obstruction. It may involve dilating the tear ducts, placing a temporary tube, or a dacryocystorhinostomy (DCR), which creates a new drainage route for tears between the lacrimal sac and the nasal cavity.

How the procedure is carried out

  • As day surgery
  • Under local or general anaesthesia, depending on the type of operation
  • Discharge the same day, after a dressing is applied over the operated site
  • You are advised to be accompanied on the way home

The precise arrangements are discussed during the consultation, according to each situation.

After the procedure

  • Sutures removed on the 7th postoperative day
  • Do not blow your nose for 10 days: simply dab beneath the nose
  • During the first few days, avoid very hot drinks and very spicy food (they tend to cause vasodilation)
  • No swimming pool or sauna for 15 days
  • No sport for 15 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction

What is it?

Facial palsy is a disorder of the facial nerve, which controls the movements of the facial muscles. When it affects the eyelids, it can compromise their closure and normal position, leaving the eye poorly protected. The two main consequences for the eye are:

  • Lagophthalmos, an incomplete closure of the eyelids
  • Paralytic ectropion, a loosening and outward tipping of the lower eyelid caused by the loss of muscle tone

These conditions expose the surface of the eye to the air and can cause significant dry eye, paradoxical watering, irritation, a foreign-body sensation, pain and, in the most severe cases, damage to the cornea that may compromise vision.

What does the treatment involve?

Treatment is tailored to each patient, according to the cause of the palsy, how long it has been present and how severe it is. The aim is to provide lasting protection for the cornea, restore effective eyelid closure and improve both comfort and appearance.

When surgery is indicated, several techniques may be proposed, alone or in combination:

  • Correction of a paralytic ectropion by re-tightening the lower eyelid
  • Implantation of a weight in the upper eyelid to help it close
  • Additional eyelid repositioning procedures where necessary

How the procedure is carried out

  • As day surgery
  • Under local anaesthesia with sedation
  • Discharge the same day, after a dressing is applied over the operated eye
  • You are advised to be accompanied on the way home

After the procedure

  • Sutures removed between the 7th and the 15th postoperative day
  • No contact lens wear for 10 days
  • No swimming pool or sauna for 15 days
  • No sport for 10 days, no vigorous or contact sport for 1 month; walking is allowed from the day after surgery
  • Reading and television without restriction
  • Make-up from the 15th postoperative day

What is it?

Blepharospasm is a neurological disorder characterised by involuntary, repeated and often bilateral contractions of the muscles around the eyes. These spasms can cause an involuntary closure of the eyelids, sometimes very frequently, making it difficult to open the eyes and potentially having a significant impact on daily activities such as reading, driving or social interactions.

What does the treatment involve?

Treatment relies mainly on injections of botulinum toxin into the muscles responsible for the spasms. Botulinum toxin temporarily reduces their activity, thereby reducing the involuntary contractions and improving eyelid opening.

The injections are given with a fine needle at several points around the eyes, according to the distribution and intensity of each patient’s spasms. The treatment is carried out in the consulting room.

The effect of botulinum toxin appears gradually over the days following the injections and generally lasts several months. The injections therefore need to be repeated regularly, according to how the symptoms evolve and how well the treatment works.

The precise arrangements for treatment are discussed during the consultation and tailored to each patient.

After the injections

  • Avoid massaging or rubbing the injected areas during the first few hours
  • Resume your usual daily activities the same day
  • Avoid intense sport during the first 24 hours

A dedicated consultation allows us to assess the indication and explain how the procedure unfolds.