Functional Oculoplastics

Numerous changes can occur to the eyelids, the surface of the eyes and the areas around the eyes and eyelids due to age related changes, medical/autoimmune processes, trauma and scarring. Often times these changes can result in changes in vision, discomfort and even disfigurement or loss of sight if left untreated. Based on your condition, Dr. Leon Rosen will tailor a treatment plan that encompasses a full host of conservative therapies as well as surgical and procedural therapies as needed.

Click on the general conditions listed below for more information:

Upper Eyelid Ptosis

The upper lids may be ‘droopy’ due to a number of factors. It commonly results from age related changes of the eyelid. It can also result from neurologic conditions, trauma or even inflammation/infections. In general, when assessing an eyelid, the position of the eyelid muscle that opens the eye, the amount of skin over the eyelids, and the brow position are important to note and address. Often there is a combination of two or even three factors that make the eyelid droopy.

Dr. Leon Rosen will evaluate your eyelid ptosis and tailor a surgical treatment plan to correct it. If the ptosis is severe enough, and can be demonstrated with special testing, insurances may cover the surgery.

If you have an eyelid ptosis, click here to make an appointment.
Ectropion
Ectropion is when the eyelids turn outwards. This commonly results from age related changes of the eyelid. It can also result from scarring from trauma or previous surgery, neurologic conditions or even tumors.Dr. Leon Rosen will evaluate your eyelid ectropion and tailor a medical and/or surgical treatment plan according to the severity of the ectropion. If you have an eyelid ectropion, click here to make an appointment.
Entropion/Trichiasis

Entropion is when the eyelids turn inwards. This commonly results from age related changes of the eyelid. It can also result from scarring from trauma, previous surgery or even conjunctivitis. Trichiasis refers to eyelashes that are abnormally turned inwards towards the eye. This commonly results from age related changes of the lid margin, scaring and tumors.

Dr. Leon Rosen will evaluate your eyelid entropion and tailor a medical and/or surgical treatment plan according to the severity of the entropion.

If you have trichiasis, Dr. Leon Rosen offers hyfrecation, which is radio frequency destruction of the lashes similar to electrolysis. This treatment option is not often found in the private practice setting.

If you have an eyelid entropion or trichiasis, click here to make an appointment.
Benign Eyelid Lesions

Ranging from sweat gland and sebaceous cysts to chalazion/styes to “moles/warts”, these lesions are as varied as they are frequent. They will commonly show changes in size and shape, thus causing concern in patients. Examination with a special microscope will often reveal the benign nature of these lesions. A simple excision procedure in the office with a local anesthetic is often all that is needed to remove these lesions.

Dr. Leon Rosen will evaluate your eyelid lesion and tailor a medical and/or surgical treatment plan according to the severity of the lesion.

If you have an eyelid lesion, click here to make an appointment.

Facial Nerve Palsy/Blepharospasm/Hemifacial Spasm

Facial Nerve Paralysis can be a result of a temporary reduction in nerve impulses to the face that spontaneously resolves, or may be a permanent process such as is the case with strokes or after removal of certain neurologic tumors. Treatment is geared towards maximizing the reduction of symptoms in the near term. Long term treatment may include surgery to correct any remaining deficits.

Blepharospasm is an uncontrollable, rhythmic, organized involuntary closure of both eyelids. This results in severe deficit for patients because its hard for them to keep their eyelids open when they are doing activities such as driving, reading or even when talking to someone else. Often confused with other eyelid conditions, patients can often go for long periods in which they are undiagnosed and untreated. To differentiate from Hemifacial Spasm, Blepharospasm does not have spasms outside of the eyelid area. Treatment involves reduction of environmental stimuli that can induce or exacerbate spasms, as well as Functional Botox therapy to alleviate the spasm temporarily.

Hemifacial Spasm is similar to Blepharospasm in that it is an uncontrollable, rhythmic, organized involuntary contracture of the facial muscles. Unlike Bleparospasm, Hemifacial spasm affects muscles of the eyelid as well as muscles of the face including the cheek, lip and jaw. As it's name implies, it is usually limited to one side of the face. Treatment involves reduction of environmental stimuli that can induce or exacerbate spasms, as well as Functional Botox therapy to alleviate the spasm temporarily.

Dr. Leon Rosen will evaluate your Facial Nerve deficit and tailor a medical and/or surgical treatment plan according to the severity of the disease process.

If you have or think you may have a Facial Nerve deficit, click here to make an appointment.
Thyroid Eye Disease

Thyroid Eye Disease (TED) refers to anatomic changes to the eyes, eyelids and orbit resulting from antibodies commonly found in patients with Grave’s Disease. These changes may occur at the same time as thyroid disease, may precede, or may come long after thyroid disease occurs. These changes can cause functional changes such dry eye exacerbation, double vision and optic nerve damage. It can also cause disfigurement due to enlargement of the tissue surrounding the eye which results in a bulging eye appearance. Early treatment may help to blunt the effect of these changes.

Dr. Leon Rosen will evaluate your thyroid eye disease and tailor a medical and/or surgical treatment plan according to the severity of the disease process.

If you have or think you may have thyroid eye disease, click here to make an appointment.

Ocular Surface Scarring

Ocular Surface Scarring can occur from drug reactions, autoimmune and inflammatory conditions or chemical burns. There is often scarring of the eyelids to the eyeball surface resulting in poor opening or closing of the eyelids or both. It can also result in poor vision from scarring to the cornea.

Dr. Leon Rosen will evaluate your Ocular Surface Scarring and tailor a medical and/or surgical treatment plan according to the severity of the disease process.

If you have or think you may have ocular surface scarring, click here to make an appointment.

If you do not see your condition listed above, click here to make an appointment so Dr. Leon Rosen can address your concerns.

Cosmetic Oculoplastics

Aging changes to the face and eyelids are inevitable. The goal of cosmetic oculoplastics is to help reduce, and in some cases, reverse some of the changes that can make us look tired, puffy and downright old.

Dr. Leon Rosen currently offers the following cosmetic services:
    Botox
    Fillers
    Upper and Lower Lid Cosmetic Blepharoplasty
If you would like to discuss options to rejuvenate your appearance, click here to make an appointment.
Oncologic Oculoplastics - Eyelid Cancer

Most people don’t realize that the skin of the eyelids is continuous with the skin of the face. As such, one can overlook the fact that a person can have “skin” cancer on the eyelids. Most bumps and tags of the eyelids are not cancers. However, if a lid lesion grows in size or changes in characteristics, or doesn’t go away, it should be looked at by a medical professional If necessary, the lesion should be biopsied to determine the nature of the lesion.

Should the lesion turn out to be cancer, Dr. Leon Rosen can remove the cancer via a technique called Frozen Section and reconstruct the eyelid at the same time. Dr. Leon Rosen also works with Dermatologists to reconstruct Moh’s Excision defects.

Orbital Tumors

The orbit is generally known as the eye socket. This is where the eyeball and its muscles and other connective tissues are located within the skull. Tumors can arise in this region that may be cancerous; whether originating from the orbit or as a metastasis from another region in the body. If a tumor does arise in the orbit, Dr. Leon Rosen will coordinate the appropriate radiologic imaging, biopsy and subsequent care with the appropriate interventionist as these tumors often need specialized treatment plans.

If you think you have an Eyelid Cancer or an Orbital Tumor, click here to make an appointment.
Tearing/Nasolacrimal Oculoplastics

Tearing in humans is a result of a multitude of factors. Some patients will have an over-production of tears from irritation of the eyes. Others will have under-drainage of the tears, whether it be from a blockage of the tear drainage system or from poor flow through the drainage system.

Tearing can often be treated only with drops. If need be, simple in-office procedures can be done to enhance topical drop therapy. Some patients with full blockage of the tear drainage system who cannot be controlled with drops may require surgery. If this is the case, Dr. Leon Rosen can bypass the blockage through an endoscopic surgical procedure which allows for reduced discomfort and accelerated recovery time following surgery.

If you have a tearing problem, click here to make an appointment.