Introduction

Department of Ophthalmic Plastic surgery, and Ocular Oncology Services

The Department of Ophthalmic Plastic surgery, and Ocular Oncology Services is a specialized medical unit within a healthcare institution that focuses on the diagnosis, treatment, and management of disorders related to the eye socket (orbit), the structures around
the eye, and various eye-related cancers.

Lacrimal system:

Nasolacrimal duct obstructions both congenital and acquired are routinely treated, with probing, balloon dacryoplasty, external/endonasal dacryocystorhinostomy and Conjunctivodacryocystorhinostomy with Jones’ tube placement. Lacrimal gland Botox for excessive watering of eye (epiphora).

Orbit services:

The orbit is the bony cavity that houses the eye and its surrounding structures. The orbit services offered by this department include the evaluation and management of a wide range of conditions affecting the orbit, such as orbital fractures, orbital tumors, orbital inflammations (orbital cellulitis), and congenital anomalies. Highly skilled ophthalmologists and oculoplastic surgeons work together to provide expert care for patients with orbit-related issues.

Ophthalmic Plastic surgery Services:

Ophthalmic Plastic surgery (oculoplasty) is a subspecialty within ophthalmology that deals with the reconstruction and restoration of the eyelids, lacrimal system, and surrounding facial structures. The Oculoplasty Services in this department offer surgical and non-surgical solutions for various conditions like drooping eyelids (ptosis), entropion (inward turning of the eyelids), ectropion (outward turning of the eyelids), Periocular Skin Grafting, injection botox in blepharospasm, hemifacial spasm and eyelid trauma. These procedures not only improve aesthetics but also aim to preserve and enhance the functionality of the eyelids and surrounding areas.

Ocular Oncology Services:

The Oncology Services in this department focus on the diagnosis, treatment, and management of eye cancers, including primary intraocular malignancies, eyelid tumors and secondary ocular tumors. These cancers may originate within the eye or spread to the eye from other parts of the body. Chemotherapy is administered for the relatively common childhood cancer Retinoblastoma, and other rarer ocular and orbital cancers both primary and as adjuvant to surgery and radiotherapy after consultation with pediatric oncologist.

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/evisceration (surgical process of removing the eye), a 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.

Team

Head of Department

Name-	Dr Narendra Patidar
Designation-	Head of Department and Consultant, MBBS- NSCB medical college, Jabalpur DOMS-MGM, Indore
Fellowship-	FCO, Sadguru Netra Chikitsalaya, Chitrakoot Fellowship in Ocular Oncology, CSF, Hyderabad Special interest in Ocular Oncology

Junior Consultants

• Dr Shruti Vashishtha
• Dr Himanshu Gaikwad
• Dr Sangeeta Bhadra

Fellow

• Dr Farheena Kulsum
• Dr Sandeep Pal
• Dr Devesh Agrawal
• Dr Dev kumar Tikam
• Dr Ashik R
• Dr Abir Mustaque
• Dr Jyotsana Soni
• Dr Vinod Chauhan
• Dr Ashutosh Chaturvedi
• Dr Gunjan Tomar
• Dr Yashodhara Singh
• Dr Palak Patwa
• Dr Devika Malhotra
• Dr Palak Jain

Ocularist

• Mrs Gayatri
• Mr Lalit Bhusan Lathera
• Mr Shyam Bihari

Collaboration Team:

Oncology Collaboration

Dr Prateek Tiwari
MBBS, MD, DM (Pediatric Oncology)

Pathology Collaboration

Dr Vinita kothari
MBBS, MD (Pathology)

Dr Poonam Arora Agrawal
MBBS, MD (Pathology)

Radiologist

Dr Prateek Gehlot
MBBS, MD (Radiology)

Services and Facilities:

Diagnostic Imaging

• The department is equipped with imaging technologies like ultrasound A and B scan, Perimetry.
• The department has excellent support facilities for AS OCT, Microbiology, X-ray unit, CT scan (JKC), Pathology and MRI (in collaboration) to accurately diagnose and monitor various orbit-related and ophthalmic conditions.

Surgical Expertise

• Highly skilled ophthalmic surgeons with specialized training in oculoplasty and oncology perform both complex and routine surgeries to address a wide range of eye-related issues.

Reconstructive Procedures:

• The department offers reconstructive procedures to restore the appearance and function of the eye and surrounding structures following trauma, cancer surgery, or congenital anomalies.

Patient-Centered Care

• The department emphasizes patient-centered care, ensuring that patients receive personalized treatment plans tailored to their specific conditions and needs.

Research and Education

• The department actively participates in research and education to advance the field of orbit, oculoplasty, and ocular oncology services.
• This involves staying up- to-date with the latest medical advancements and training the next generation of eye specialists through residency and fellowship programs.

Collaborative Approach

• Given the complexity of some of the conditions treated in this department, a collaborative approach involving various specialists, such as neurosurgeons, oncologists, and plastic surgeons, may be employed to achieve the best outcomes for patients so the patient is referred after complete work up to the possible nearest higher center for further management.

Statistics/Service Delivery

Fellowship Programs

The Institute offers a 3 year fellowship in Comprehensive Ophthalmology. Training includes clinical, surgical, educational and research activities.

This unique program trains in the entire spectrum of ocular-adnexal disorders and cataract surgery. During the course of the fellowship, a fellow becomes accomplished in the diagnostic evaluation, medical and surgical treatment of eyelid disorders like upper and lower lid Entropion, ectropion, Simple mass excision of lid, Lid tear repair with minimanoka stent, lacrimal procedures like Simple and complex external DCR, DCT, Punctal Cautery, Punctoplasty. Exposure to orbital disease and orbitotomy, simple and four petal Evisceration, enucleation, lid reconstruction, skin grafting, Mucous membrane graft, exposure to various cosmetic procedures like Injection Botox. Exposure to ocular oncology, such as managing Retinoblastoma and other orbital tumours.

• A comprehensive exposure to Simple and Complex Manual SICS is given over the course of the 3 year program, together with a good exposure to Phacoemulsification cases.

Research programs

Ophthalmic plastic surgery and ocular oncology are the main areas of research within the department and in collaboration with several ophthalmic institutes affiliated with BODHA EYE CONSORTIUM (BEC).

Additionally, the research program is centered on the topic of General Ophthalmology in collaboration with other departments at the Institute.

Our publications:- (2020 onwards)

• Tiple S, Kimmatkar P, Das S, Muralidhara A, Nehashree, Mehta A, Patidar N, Jain E. Treatment outcomes of oral propranolol in the treatment of periocular infantile capillary hemangioma and factors predictive of recurrence and incomplete resolution: A multi- centric study. Oman J Ophthalmol. 2023 Feb 21;16(1):75-81. doi: 10.4103/ojo.ojo_11_22. PMID: 37007245; PMCID: PMC10062112.
• Garg G, Patidar N, Dubey S. A rare presentation of bilateral ophthalmic relapse of pediatric chronic myeloid leukemia: Multimodal imaging and treatment. Oman J Ophthalmol. 2023 Jun 27;16(2):359-362. doi: 10.4103/ojo.ojo_343_21. PMID: 37602176; PMCID: PMC10433038.
• Pal, Sandeep; Mehta, Ayush; Agrawal, Poonam Arora1; Patidar, Narendra; Kulsum, Farheena. A rare case of congenital ectopic eyelid tissue. Indian Journal of Ophthalmology - Case Reports 3(1):p 145-147, Jan–Mar 2023. | DOI: 10.4103/ijo.IJO_1731_22
• Pal, Sandeep Patiram; Patidar, Narendra; Gabba, Harshdeep Singh; Gaikwad, Himanshu; Nikhade, Saurabh1; Agrawal, Poonam Arora2. A rare case of orbital and diffuse conjunctival venous malformation. Indian Journal of Ophthalmology - Case Reports 3(3):p 798-800, Jul–Sep 2023. | DOI: 10.4103/IJO.IJO_3067_22
• S., Pal; P.A., Sen; N., Patidar; H.S., Gabba; S., Bhadra (2023). Supplementary Material for: A Rare Case of Direct Spontaneous Carotid-Cavernous Fistula In a 6-month-old Infant and Review of literature. Karger Publishers. Dataset. https://doi.org/10.6084/m9.figshare.23684169.v1
• Ashik R, Pal S, Patidar N, Gabba HS, Gaikwad H. Subconjunctival and Perioptic Vascular Lesion in Asymptomatic Moyamoya Disease - A Rare Ocular Presentation. Neurol India. 2023 Jul-Aug;71(4):802-803. doi: 10.4103/0028-3886.383829. PMID: 37635531.
• Garg G, Patidar N, Dahiya V. Orbital cellulitis complicated by central retinal artery occlusion with sparing of cilioretinal artery: A case report and review . Indian J Ophthalmol Case Rep 2022;2:235-9. DOI : I0.4103/ijo.IJ0_ 740_21
• Gabba HS, Garg G, Warkade RP, Agarwal A, Mehta A, Agarwal R. A rare presentation of neonatal retrobulbar orbital abscess secondary to acute dacryocystitis. Indian J Ophthal mol Case Rep 2022;2:2 I 7-9. DOl: I 0.4103/ijo.IJ0_ 1210_21
• Gaurav Garg, Narendra Patidar, Ranu Gupta. Anterior segment optical coherence tomography features of peripunctal nevus. IJO Case Reports; Vo. I, issue.4 Oct-Dec 2021 -p.717 ; DOI:10.4103/ijo.IJO_401_21
• Shenoy, Pratik; Mehta, Sonali; Shah, Chintan, Joshi R, Sen P, Patidar N. and More/ Comparison of post-cataract surgery endophthalmitis rates using syringing or regurgitation on pressure over the lacrimal sac as a preoperative screening tool for nasolacrimal duct obstruction: An impact assessment of protocol
• Gaurav Garg*, Rukmendra Pratap Singh Warkade, Narendra Patidar, Ranu Gupta and Harshdeep Singh Sep Gabba. A Rare Presentation of Intraorbital Abducens Nerve Schwannoma. Acta Scientific Medical Sciences Vol.5(9) Sep 2021, Pg.1 16-118 (ISSN: 2582-0931)
• Mrittika Sen, Santosh G Honavar, Rolika Bansal, Sabyasachi Sengupta, Rukmendra PS Wa rkade ets Jul all. Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino- orbital-cerebral mucormycosis in 2826 patients in India - Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report I. Indian Journal of Ophthalmology: July 2021 - Volume 69 - Issue 7 - p 1670-1692. doi: 10.4103/ijo.IJO_l 565_21
• Jaiswal H, Patidar N, Shah C, Singh R, Jain E, Piyush .P. Topical timolol 0.5% as the primary treatment of ophthalmic pyogenic granuloma: A prospective, single-arm study. Indian J Ophthalmol. 2021 May;69(5):1 155-1160. doi:I 0.4103/ijo.IJ0_2404_20. PMID: 33913850; PMCID:PMC8186631.
• Agarwal A, Patidar N, Gabba HS, Sood D, Piush P. Pain Score Assessment Using Single-Dose IV Ketorolac Only, After External Dacryocystorhinostomy: A Randomized Double/Triple-Blind Placebo-Controlled Trial. Ophthalmic Plast Reconstr Surg. 2021 Mar-Apr 01;37(2):173-175. doi: I 0.1097/IOP.0000000000001730. PMID: 32467522.
• Agarwal R, Patidar N, Mohan A, Singh R, Sen P. Pattern of Presentation and Surgical Outcomes of Canalicular Laceration Repair in a Pediatric Population. J Pediatr Ophthalmol Strabismus. 2021 Jan 1;58(1):42-47. doi:10.3928/01913913-20201007-02. PMJD: 33495797.
• Narendra Patidar , Prerana Phadnis , Amit Mohan , Parimal Piush. A rare case of traumatic superior orbital fissure syndrome following an unusual mode of penetrating injury.-Case Report- Delhi Journal of Ophthalmology. Vol. 3 I,No. I,July-September 2020.
• Patidar N, Agrawal S, Singh RP,Phadnis P. Orbito-sinal foreign body with floor fracture: an unusual presentation. GMS Ophthalmol Cases. 2020 A ug 6;10:Doc32. doi: 10.3205/oc000159. PMID: 32884886; PMCJD: PMC7452952.