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Oculoplastic Clinic in Chuo-ku, Ginza, Tokyo OCULO FACIAL CLINIC TOKYO|Ophthalmology / Plastic and Reconstructive Surgery

OCULO FACIAL CLINIC TOKYO

Medical Services

We provide oculoplastic treatments that can solve your problems and meet your needs.

Graves’ disease / Thyroid eye disease

This disease used to be called “beautifying disease,” because of the exophthalmos and widened palpebral fissure following onset of the disease.
However, we think in most cases facial expression gets rather worse because of the widened palpebral fissure.

Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disease of the eyelid, lacrimal gland, extraocular muscle of the retrobulbar soft tissue, or fat tissue, associated with Graves’ disease or sometimes Hashimoto’s disease.
-2007 “Diagnostic criteria and treatment guidelines for malignant exophthalmos associated with Graves’ disease” Preparation Committee

Symptoms associated with Graves’ disease / thyroid eye disease

  • Eye pain
  • Foreign body sensation
  • Visual loss
  • Retro-orbital pain
  • Double vision
  • Excessive tearing
  • Disfiguring

A disease that changes facial expression

A big change in your facial expression might also change your life.
Some people feel uncomfortable being around people and start staying at home all the time.

  • Before onset of Graves’ disease

  • After onset of Graves’ disease

Learn more in external website (Dr. Kashima’s website)

Ptosis & Dermatochalasis

Ptosis is a condition in which sagging upper eyelid is narrowing the eye opening.
Ptosis is caused by abnormality in the muscles that raise the upper eyelid (levator palpebrae superioris muscle, Muller’s muscle) and their aponeurosis (levator aponeurosis) and innervating nerves. Congenital ptosis is caused by the improper development of the levator muscle. It is often unilateral, but can also be bilateral. Acquired ptosis is a condition in which the contraction of the levator muscle is not transmitted to the upper eyelid because of stretching or disinsertion of the levator aponeurosis due to aging. It is mostly unilateral.
Acquired ptosis may also occur due to poor levator muscle function following trauma or disease (ocular myopathy, etc.).

Treatment of Ptosis & Dermatochalasi

Skin incision

Incise the eyelid skin along the crease at 5mm from the lid margin and remove any excess skin.
Remove the thin filmy muscles that raise the upper eyelid (levator palpebrae superioris muscle, Muller’s muscle) from the surrounding tissues. Then suture the shortened levator aponeurosis onto the hard tissue called tarsus.
Make a double eyelid and suture the wound.

Conjunctival incision

Lift the eyelid by tightening the conjunctiva and the muscle by making incision on the inside of the eyelid. A gritty sensation may last for about one week.
We determine the amount of correction during the surgery, but sometimes the result turns out to be different from the estimate. In this case, some additional surgery such as re-suturing may be necessary.

Change after surgery

The eyes are wide open with double eyelid.
The face changes from a sleepy look to a lively look.

  • Before surgery

  • After surgery

Adverse effects, risks, and cautions of ptosis & dermatochalasis treatment

  • The surgery is performed under local anesthesia in principle in order to confirm the shape of the eyelid during the surgery. However, general anesthesia is used in the case of pediatric patients or in other circumstances.
  • Sedation may be used before surgery to reduce pain.
  • You may feel dull pain during surgery under local anesthesia. If the pain is too strong, we may add anesthetics or administer analgesics.
  • Patients who have gone through several surgeries tend to feel more pain.
  • We try to minimize the difference between the two eyes, but completely bilateral finish is impossible. If the difference turns out to be too big after the surgery, we may perform re-suturing or another surgery.
  • The scar will be gradually invisible after surgery, but occasionally it may remain visible or become keloidal.
  • For any wound dehiscence after surgery, re-suturing will be necessary.
  • There is a risk of orbital phlegmon due to infection.
  • When sedation is used during surgery, there is a risk of blood pressure decrease, bradycardia, respiratory depression, and other reactions.

Learn more in external website (Dr. Kashima’s website)

Treatment of Ptosis & Dermatochalasis

Facial paralysis

The facial nerve is the nerve of facial expression. Facial paralysis is caused by various reasons, but as it causes facial asymmetry, the patient’s facial appearance will change drastically.
Eyelids are supposed to protect the eyes, but in the case of a patient with facial paralysis, the lower eyelid is sagging and the upper eyelid is left raised, resulting in dry eye.
The facial appearance and dry eye of the facial paralysis patients can be drastically improved by surgery.

Lift the eyebrow and fix the ectropion of the lower eyelid
to make symmetrical eyelids.

  • Before surgery

  • After surgery

Learn more in external website (Dr. Kashima’s website)

Treatment of facial paralysis

Single eyelid

Even those people who are born with single eyelid can have a double eyelid,
which will widen their views and enlarge their eyes.
It is also possible to form a double eyelid without cutting open the skin (burial method)

  • Before surgery

  • After surgery

Ingrown eyelashes & Mongolia fold

Entropion is a condition in which the eyelid turns inward so that the eyelashes rub against the eye surface. This causes various symptoms.

Surgical procedure

Make an incision on the skin near the eyelash and suture the inside to turn the eyelid and eyelashes outward.
The incised wound after surgery will form a double eyelid.

  • Before surgery

  • After surgery

Learn more in external website (Dr. Kashima’s website)

Treatment of ingrown eyelashes

Epiphora

When the nasolacrimal duct that carries tears to the nasal cavity is blocked, tears cannot drain normally, causing tears to flow out of the eye.
This is the cause of epiphora.
It can be treated either by opening up blockages and narrowing within the tear drainage system using tiny endoscopes and tubes, or by making an incision in the wall of the lacrimal sac to create a new route for tears to drain out directly through the nose.

  • Normal tear duct
    A tear drainage system that lets tears flow down through the nose.
  • Blocked tear duct
    Tears cannot drain and overflow out of the eye.

Learn more in external website (Dr. Kashima’s website)

Cause of epiphora

Bags under eyes

The fat moves into the lower eyelids with aging causing the lids to appear puffy. This makes a tired look on the face.
Possible treatment includes surgery and injection of hyaluronic acid.

Treatment of bags and dark circles under eyes

In case of a mild swell, injection of hyaluronic acid is recommended.
Bags under eyes make you look tired.
You can recapture a youthful look by removing the dark circles.

  • Before surgery

  • After surgery

Learn more in external website (Dr. Kashima’s website)

Bags under lower eyelid

Trauma repair surgery

Injuries can happen out of the blue. You have no choice.
Or sometimes you receive improper treatment. In those cases, a repair surgery would be necessary.

  • Before surgery

  • After surgery

Learn more in external website (Dr. Kashima’s website)

Trauma repair surgery