About Orbital Services at Madurai

Orbit, Oculoplasty, Ocular Oncology & Ocular Prosthetic Services, a subspecialty of ophthalmology handles anomalies of lids, lacrimal drainage system, extra ocular structures, bony orbit and other ocular adnexa. In the last 20 years, the clinic has seen over 376,867 patients and performed over 117,000 surgeries.

The department has excellent support facilities, diagnostic equipment like Ultrasound A & B Scan, X-ray unit, CT scan, MRI (in collaboration), well established Ocular Microbiology, Pathology, Immunology and Genetic labs. Standard surgical theatre is provided with operating microscope, surgical lights, fiber optic light, bipolar and unipolar cautery unit, Ellman Radio frequency cutting- coagulating system, latest state of the art Navigation system  and endoscopic  surgery equipment with radiotherapy (in collaboration) and chemotherapy facilities.

Orbit

The Orbit Clinic receives a number of referrals encompassing both common and rare orbital disorders, tumours and infections. These are managed both conservatively (medical management/chemotherapy/ radiation) and surgically with tumour and the tissue being sent biopsy and histopathological correlation. A large number of patients with thyroid related orbitopathy are also treated in collaboration with the general physician and endocrinologist on a daily basis.

Lacrimal system and Orbit

Nasolacrimal duct obstructions both congenital and acquired are routinely treated, with probing, balloon dacryoplasty, external/endonasal dacryocystorhinostomy and Conjunctivodacryocystorhinostomy with Jones’ tube placement.  A number of patients with orbital pathology including orbital trauma are seen in the clinic. Orbitotomy with mass incisional/ excision biopsies and orbital floor fracture repair with implants (silicon, prolene mesh and osteopore) are commonly done. Orbital and wound exploration for foreign body and their removal are also expertly handled.

Orbit and Oculoplasty services are available at Aravind – Madurai, Chennai, Tirunelveli, Coimbatore, Pondicherry.

Oculoplasty

A number of patients are seen in the Oculoplasty clinic with a variety of eyelid disorders including malpositions (Ptosis, Entropion, Ectropion), benign and malignant eyelid tumours, facial dystonias etc. Congenital lid anomalies including lid coloboma, blepharophimosis, epiblepharon and euryblepharon are also surgically corrected. Surgical corrections for ptosis, entropion, ectropion, post traumatic lid tear / canalicular tear, eyelid reconstructions post tumour removal as well as number of cosmetic eyelid surgeries (e.g. Blepharoplasty) and injection of botulinum toxin (Botox) for facial dystonias and cosmetic indications are being performed.

Orbit and Oculoplasty services are available at Aravind – Madurai, Chennai, Tirunelveli, Coimbatore, Pondicherry.

Ocular Oncology

Adult and paediatric malignancies of eyelids, ocular surface, orbit and globe 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, in consultation with an oncologist. A trained nurse attends to the patients’ needs while an experienced medical officer stops by for regular check-ups. The clinic is now a referral centre.

Ocular Oncology service is available at Aravind – Madurai, Coimbatore and Tirunelveli.

Ring of Hope

Ring of Hope fund provides free treatment and rehabilitation to patients suffering from eye cancer.  Cancer treatment which includes diagnosis, genetic testing, surgery, chemotherapy and radiation can be a catastrophic event for any family, burdening them with debt. Ring of Hope also pays for travel and accommodation so that those costs do not become an obstacle to continuing treatment.

In some cases, Aravind can save a patient’s life, but not sight.  Orbital cancers can cause disfigurement and blindness, destroying self-esteem and limiting active participation in the community.  Aravind’s team of expert ocularists created 250 custom prostheses for patients who had an eye removed – roughly half of them were provided free through the Ring of Hope.  The Ring of Hope also provides rehabilitation services and devices for patients who have low vision or are blind.

Ocular Prosthesis

Ocular Prosthesis is an artificial eye or aesthetic model of eyelids and globe which is fit for patients with phthisis bulbi or those whose eyes or orbital contents including globe have been surgically evacuated. During enucleation (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. A silicone facial prosthesis is also fashioned in the department, for patients who undergo exenteration (removal of orbital contents long with the eyeball) for various oncological/ infective indications.

The Ocular Prosthesis Centre was established in 2004 and is equipped to cater to challenging cases with excellent results. 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 10,220 satisfied patients. For patients with exenterated socket, silicone facial prosthesis is offered.

Ocular Prosthetics service is available at Aravind-Madurai only.

Orbit Clinic - Diagnostic and Treatment

The department focuses on evaluation, diagnosis and management of the orbital disorders. The department has excellent diagnostic facilities like Ultrasound A& B Scan, and well-established support systems such as X-ray unit, CT Scan, MRI, Ocular Microbiology, Pathology, Immunology and genetic labs. Standard surgical theatre is provided with operating microscope, surgical light, fibre optic light, bipolar, unipolar cautery unit, Ellman Radio frequency cutting-coagulating system, Navigation system for orbital surgeries, endoscopic  surgery equipment, radiotherapy and chemotherapy facilities, plastic procedures for Entropion, Ectropion, Ptosis, Lid reconstruction, various graft/Flap surgeries, DCT, DCR, Enucleation, Evisceration, Exenteration, Socket reconstruction, Orbital implants and Orbitotomies.

Commonly seen conditions

  • Ptosis, Entropion, Ectropion,lagophthalmos, Trichiasis, Distichiasis
  • Thyroid related eye diseases
  • Orbital wall fractures / zygoma fracture
  • Naso lacrimal duct abnormalities – congenital and acquired
  • Tumours – of eyelid and orbital origin and Retinoblastoma
  • Anopthalmic socket

Orbit Clinic - Our Doctors

ARAVIND – TIRUNELVELI
Chief
Medical Consultants
ARAVIND – PONDICHERRY
Chief
Medical Consultants
ARAVIND – CHENNAI
Medical Consultants

Orbit Clinic - Ongoing Research

The department works in close conjunction with the Aravind Medical Research Foundation for studying the genetics of Ocular conditions (Retinoblastoma, Blepharophimosis syndrome, Lymphomas and other adult malignancies).

On-going research:

  1. Oral Clonidine premedication in patients undergoing dacryocystorhinostomy under local anesthesia
  2. National Retinoblastoma Regisrty (ICMR)
  3. Randomized, double blind, active control study of the efficacy, surgical outcome and complications of Silicone Rod Sling in frontalis sling suspension surgery.
  4. Socket Reconstruction using Bio-Engineered Autologus Oral Mucosal Epithelium.
  5. Corneal Surface reconstruction using Bio-Engineered Autologus Oral (Buccal) Mucosal Epithelium.
  6. Developing Xenobiotic – free culture conditions to generate stem cell Rich Epithelium for Corneal surface reconstruction.
  7. Factors responsible for the generation of Epithelial sheet rich in Stem cells under ex-vivo conditions from the Limbal and Buccal Biopsy.
  8. Prospective clinical evalutation of Dacryocystorhinostomy(DCR) with lacrimal intubation.

Major Publications

 

 

Orbit Clinic - Training

Currently, the department manages  long term (for  candidates within India) and short term (for international candidates) fellowship courses. Each fellow has blossomed into a successful practitioner of this specialty in different parts of the country. Ocularist course for national and international candidates is also offered.

Long Term Ophthalmology Fellowship

Fellowship in Orbit and Oculoplasty 

  • This course is available at Aravind Eye Hospitals in Madurai, Tirunelveli, Coimbatore, Pondicherry

Short Term Ophthalmology Fellowship

Fellowship in Orbit and Oculoplasty 

  • This course is available at Aravind Eye Hospitals in Madurai

Short Term Paramedical Course

Training for Ocularist 

  • This course is available at Aravind Eye Hospitals in Madurai