Speciality Clinics

Ring of hope

Overview

Orbit, Oculoplasty, Ocular Oncology & Ocular Prosthetic Services, a subspecialty of ophthalmology handles anomalies of lids, the lacrimal system, extraocular structures, the bony orbit, and other ocular adnexa. It mainly focuses on the evaluation, diagnosis, and management of orbital and adnexal disorders. The department has excellent support facilities, advanced diagnostic equipment, and comprehensive documentations through Electronic Medical records (EMR), ensuring the highest quality care. In the last 24 years, the clinic has seen over 647596 patients and performed over 147229 surgeries.

Orbit

The orbit clinic receives a number of referrals encompassing both common and uncommon orbital disorders (tumours; benign and malignant) and infections. These are managed both conservatively (medical management/chemotherapy) and surgically with tumour removal and the tissue/sample sent for Histopathological correlation. A large number of patients with thyroid related orbitopathy are treated in collaboration with the general physician and endocrinologist (outside collaboration) on a daily basis.

Lacrimal system and Orbit

Nasolacrimal duct obstructions, both congenital and acquired, are routinely treated in this clinic with probing, external/endonasal dacryocystorhinostomy with or without an intubation tube, laser DCR Jones’ tube placement, and balloon dacryoplasty. A number of patients with orbital pathology, including orbital trauma, are seen here. Orbitotomy with mass incisional/ excision biopsies and orbital floor fracture repair with implants (silicon, prolene mesh and osteopore mesh) are commonly done. Orbital and facial bone reduction with internal fixation is done alongside a maxillofacial surgeon (outside collaboration).

Oculoplasty

A number of patients are seen in the Oculoplasty clinic daily, addressing various eyelid disorders, including lid malposition (Ptosis, Entropion, Ectropion), benign and malignant eyelid tumours, facial dystonias etc. The clinic also perform surgical corrections for ptosis, entropion, ectropion, post-traumatic lid tear/canalicular tear, eyelid reconstructions post-tumour removal as well as a number of cosmetic eyelid surgeries (e.g. Blepharoplasty) and injection of botulinum toxin (Botox) for facial dystonia and cosmetic indications.

Ocular Oncology

Adult and paediatric malignancies of the orbit are diagnosed and managed in the oncology clinic. Chemotherapy is administered for the relatively common retinoblastoma, and other rarer ocular and orbital cancers, both primary and as adjuvant to surgery and radiotherapy. Chemotherapy sessions are administered at Aravind Eye Hospitals in consultation with an oncologist specialising in both adult and paediatric oncology. A trained staff nurse attends to the patients’ needs while an experienced medical officer stops by for regular check-ups. The oncology clinic is now a referral centre.

Ring of Hope

“The Ring of Hope” fund has helped many in receiving chemotherapy without any charges. To date it has helped serve 8026 children and adults who otherwise would have been unable to access crucial medical care, and during their stay, the children and their families are provided free food and accommodation.

Ocular Prosthesis

Ocular prosthesis is an artificial eye, fitted for patients whose eyes have been removed and for those with phthisis bulbi. During enucleation (the surgical process of removing the eye), a silicone ball implant is inserted into the eye socket to fill the area the eye once occupied. An ocular prosthesis is then moulded to fit in front of the implant. It occupies the space between the eyelids and the conjunctiva, covering the implant.

The ocular prosthesis centre was established in 2004 and is equipped to cater to challenging cases with excellent results, and the centre has witnessed a significant growth in the number of custom-made prostheses. It is now one of the leading centres in India for custom fitting of artificial eyes. Since inception, the centre has fulfilled the prosthetic requirement of over 18,312 satisfied patients. For patients with an exenterated socket, silicone facial prostheses (over 83 in number) are fitted, with a satisfied response from patients.

Diagnosis & Treatment

Scope of Services

The department focuses on the evaluation, diagnosis, and management of the orbital disorders. It has excellent support facilities, and diagnostic equipment like ultrasound A-scan & B-Scan, X-ray unit, AS-OCT and UBM. Computerised Tomography Scan, Magnetic Resonance Imaging, ocular microbiology, pathology, immunology, and genetic lab well established. The standard surgical theatre is provided with an operating microscope, surgical light, fibre optic light, a bipolar and an unipolar cautery unit, an endonasal endoscope, an Ellman Radio frequency cutting-coagulating system, radiotherapy, chemotherapy, facilities plastic procedures like entropion, ectropion, ptosis, lid reconstruction, various graft/flap surgeries, DCT, DCR, enucleation, evisceration, exenteration, socket reconstruction, orbital implants and orbitotomies. This department specialises in the care of diseases of the orbit, the eyelids, & the lacrimal drainage system.

Commonly Managed Diseases:
  • Ptosis, Entropion, Ectropion, Lagophthalmos, Trichiasis, Distichiasis
  • Thyroid related eye diseases
  • Orbital wall fractures/zygoma fracture
  • Nasolacrimal duct abnormalities – congenital and acquired
  • Tumours – of eyelid and orbital origin and Retinoblastoma
  • Anopthalmic socket, contracted sockets

Facilities
The department is supported by a well-equipped ocular pathology, microbiology & genetics department.

Endoscopy
Cases of Dacryocystitis and other allied surgeries can be tackled through the nasal route by means of an endoscope. The advantage is that an external scar is avoided. An ENT, neurosurgeon, plastic surgeon, and faciomaxillary surgeon are also attached as on-call consultants.

Orbitotomy
Surgical treatment for orbital tumours

Socket Reconstruction:
Surgical restoration of deformed sockets to improve cosmetic appearance

Ocular Prosthetics
There are three-full time skilled ocularists to make customised artificial eye shells, and facial prostheses to rehabilitate patients who have lost an eye due to various reasons.

Ocular Oncology
A special ocular oncology unit provides comprehensive care for patients with eye cancers.

Investigations
• Intra Ocular Pressure
• Duct Syringing, Probing, and Punctal dilatation
• CT-scan/ MRI
• USG, UBM
• Thyroid Blood Investigations
• Blood Investigations
• Biopsy: Exfoliative cytology/ Impression cytology/ frozen section
• CT Guided Biopsies

Patient Counselling
There is constant emphasis on patient education, fully trained counsellors who handle queries and provide information on the investigative procedures, laser treatment, surgery, costs involved, and the visual prognosis in a language familiar to the patients. The importance of regular follow-up visits is stressed, and the patient will be given an appointment for the same.

Our Doctors

ARAVIND – MADURAI
Chief
Dr. Usha Kim, DO, DNB
Medical Consultants
Dr. Meghana Tanwar, DO, DNB
Dr. Vinitha L Rashme, MS
Dr. Rama Vadapalli, MS
ARAVIND – COIMBATORE
Chief
Dr. Viji Rangarajan, DO
Medical Consultants
ARAVIND – PONDICHERRY
Chief
Dr. R. Jayagayathri, DO, DNB
Medical Consultants
ARAVIND – TIRUNELVELI
Chief
Dr. V. Maneksha, MS
Medical Consultant

Dr. E. Keerthana, MS

ARAVIND – CHENNAI
Medical Consultants
Dr. Jayashree, DNB
Dr. Anupama Joy, DO MS, DNB
Dr. Vikas Menon, DNB
Dr. Arjun D, DNB
ARAVIND – TIRUPATI
Medical Consultant
Dr. Preeti Mohanty, MS, DNB

Our Research

Clinical research is, and has always been, crucial to furthering the understanding of ophthalmic conditions, treatment, and prevention. The department works in close conjunction with the Aravind Medical Research Foundation (AMRF) for studying the genetics of ocular conditions (Retinoblastoma, Blepharophimosis syndrome, Lymphomas and other adult malignancies).

Major Publications