Oculoplastic & Reconstructive Surgery

Eyelid abnormalities can develop due to aging, genetics, trauma, or underlying medical conditions—and often affect both appearance and function. These conditions may lead to discomfort, visual obstruction, or irritation and are best addressed by a specialist trained in both ophthalmic and reconstructive surgery. At Park Avenue OculoPlastic Surgeons, each condition is carefully evaluated and treated with a surgical approach tailored to the individual’s anatomy and needs.

How Surgery for Eyelid Abnormalities Works

Treatment for eyelid abnormalities typically involves outpatient surgery to restore proper eyelid position and function. Depending on the diagnosis, procedures may include tightening of the eyelid tendons, removal of excess skin or tissue, or repositioning of the eyelid margin. These surgeries are performed with precision to protect the eye while improving comfort, appearance, and in many cases, visual field.

Conditions This Can Address:

• Ptosis: Drooping of the upper eyelid that may obstruct vision or cause fatigue
• Dermatochalasis: Excess upper eyelid skin leading to heaviness, a tired appearance, or visual obstruction
• Ectropion: Outward turning of the lower eyelid causing tearing, irritation, and redness
• Entropion: Inward turning of the eyelid, often causing lashes to rub against the eye, leading to discomfort or damage
• Eyelid malpositions caused by trauma, scarring, or previous surgeries
• Chronic tearing or eye surface irritation due to poor eyelid support

How We Correct Tear Drain System Abnormalities

Treatment often involves creating a new drainage pathway between the tear sac and nasal cavity, typically through a minimally invasive, endoscopic approach. This non-incisional method avoids external scarring and allows for faster recovery. Depending on the cause and severity of the blockage, additional techniques such as balloon dilation or stent placement may also be used.

Conditions This Can Address:

• Chronic tearing (epiphora) due to blocked tear ducts
• Recurrent dacryocystitis (tear duct infections)
• Nasolacrimal duct obstruction in adults
• Congenital tear duct blockages
• Incomplete or narrowed tear drainage pathways
• Previous failed lacrimal surgeries requiring revision

The orbit—commonly referred to as the eye socket—is a highly complex structure composed of bone, fat, muscles, nerves, and blood vessels that support and protect the eye. Orbital conditions may arise from trauma, tumors, systemic disease, or congenital abnormalities, and can significantly impact vision, eye movement, and appearance. As fellowship-trained oculoplastic surgeons, Dr. Popham and Dr. Vaishnav are uniquely qualified to treat these delicate structures with precision and care.

How We Correct Eye Socket Abnormalities

Surgical treatment of orbital conditions typically involves carefully repositioning displaced tissues, removing masses, or decompressing areas of pressure around the eye. These procedures often require advanced imaging, specialized approaches such as transconjunctival (no visible incision) access, and deep knowledge of orbital anatomy. Each case is evaluated individually to determine the safest and most effective surgical plan, with the goal of restoring both function and appearance.

Conditions This Can Address:

• Orbital Floor / Blowout Fractures: Repair of fractures from trauma that may cause double vision, sunken eyes, or restricted eye movement
• Orbital Tumors: Biopsy and removal of benign or malignant masses causing displacement, vision loss, or pain
• Thyroid Eye Disease (Graves’ Orbitopathy): Management of eye bulging, double vision, or optic nerve compression from autoimmune thyroid-related inflammation
• Enophthalmos / Hypoglobus: Correction of sunken or displaced eyes following trauma or bone loss
• Proptosis (eye bulging): Reduction of eye protrusion using orbital decompression techniques
• Congenital or developmental orbital abnormalities

Certain neurologic or muscular conditions can lead to involuntary facial movements such as chronic eyelid twitching, facial spasms, or even sustained eyelid closure. These issues—often categorized as muscle dystonias—can severely affect vision, comfort, and quality of life. At Park Avenue OculoPlastic Surgeons, these conditions are managed with advanced precision, using non-surgical interventions like BOTOX® to safely restore function and comfort.

How We Correct Facial Muscle Abnormalities

BOTOX® (botulinum toxin type A) is used to block nerve signals that cause abnormal muscle contractions, offering relief for conditions like blepharospasm (involuntary eyelid closure), hemifacial spasm, and facial nerve dysfunction. Injections are quick, typically completed in under 15 minutes, and effects last approximately three to four months. Dr. Popham has been treating medical muscle dystonias with BOTOX® since 1990 and is nationally recognized for his expertise in both functional and cosmetic applications.

Conditions This Can Address:

• Blepharospasm: Chronic, involuntary eyelid closure that may impair vision
• Hemifacial Spasm: Twitching or contraction of muscles on one side of the face
• Facial Contractures: Muscle tightening following nerve injury or trauma
• Facial Nerve Disorders: Resulting in asymmetry or uncontrolled movements
• Migraine-Associated Muscle Tension: Select cases managed with targeted injections
• Medical indications for BOTOX® in patients with movement disorders

Reconstructive surgery restores both form and function to the delicate structures surrounding the eyes, particularly after trauma, medical illness, or previous surgery. Dr. Popham is a nationally recognized oculoplastic surgeon with extensive experience in addressing complex facial and orbital concerns — especially in cases where vision, appearance, or tear function are affected. His focus is on achieving results that are medically sound, functionally effective, and aesthetically refined.

How Does Reconstructive Surgery Work?

Depending on the condition, reconstructive surgery may involve repairing damaged tissues, repositioning displaced structures, or reconstructing features that have been altered by trauma, disease, or prior procedures. These surgeries are highly individualized and may use both traditional and endoscopic techniques to minimize scarring and preserve natural anatomy. In many cases, reconstruction also helps restore vision, tear function, and facial balance.

What Reconstructive Surgeries Can Address:

• Eyelid reconstruction following trauma, tumor removal, or prior surgery
• Tear drainage system repair or reconstruction
• Orbital fracture and trauma repair after accidents or blunt force injuries
• Correction of complications from prior cosmetic eyelid procedures
• Reconstruction following skin cancer excision or Mohs surgery
• Management of thyroid eye disease (Graves’ orbitopathy)
• Treatment of congenital or acquired deformities affecting the upper face or eye socket