ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Orbit counselling

 The orbit is a pyramidal bony cavity  It contains the eye ball, extra ocular muscles, fats, blood vessels and important nerves  It is formed by a roof, floor, medial wall, lateral wall, and a base and apex  The bony orbit is made of 7 bones What is Orbit?

7 bones of Orbit 1.Frontal bone 2.Sphenoid bone 3.Zygomatic bone 4.Maxillary bone 5.Palatine bone 6.Ethmoid bone 7.Lacrimal bone Orbit picture

  Lacrimal Drainage Disorders include condition like obstruction of the tear drainage passage, and inflammation of the lacrimal sac   If affects children & adults   It is of two types 1. Acute 2. Chronic Lacrimal Sac pictures Lacrimal Drainage Disorders

1.Watering 2.Discharge (mucous or pus) 3.Severe pain 4.Swelling 5.Redness Symptoms

1.Syringing 2.Complete Hemogram (Blood group, Blood type, Bleeding time, Clotting Time) 3.Blood Pressure 4.Blood Sugar 5.HIV Test Investigations

Treatment A.Acute Dacryocysititis :  Systemic pain killers  Anti Inflammatory Drugs  Antibiotics  If Lacrimal abcess forms, the pus may have to be surgically cleaned out (Incision and Drainage)  After the pain and swelling resolves, the patient usually requires surgery like DCR or DCT

B. Chronic Dacryocystitis The treatment consists of sac surgery 1.DCR (Dacryo Cysto Rhinostomy) 2.DCT (Dacryo Cysnostomy)

DCR  The Sac is incised and passage for tear flow into the nose is created by removing a part of the bone  In Adults it is done under local aneasthesia

DCT  This is done for above 40 years patients  The whole lacrimal sac is removed  After surgery patient has watering complaints

Congenital naso – Lacrimal Duct obstruction  The initial treatment consists of criggles lacrimal massage supplemented with anti biotic eye drops  In most children the passage opens up with, probes criggles massage  If probing fails, surgery is done, usually after the child is 3-4 years only

Probing  It is a very safe and simple procedure  A thin metal rod is used to open up the lacrimal passage, by removing the obstruction  This is done by General Anaesthesia

Role of the counsellors in lacrimal drainage procedures  The counsellor should explain to the patient that the lacrimal sac is infected and needs to be treated surgically  The counsellor should explain to the child’s parents that obstruction of the Naso – lacrimal duct is not a major problems  If probing has been advised, the counsellor should explain, that is not a surgery but a very simple procedure  It is done under general anaesthesia