Diagnosing and investigating conditions that might require oculoplastic surgery was the subject of a presentation given by Nepur Patel at the AOP’s Hospital and Specialty Optometrists Conference (HSOC) 2024.
Patel, principal optometrist in the adnexel service at Moorfields Eye Hospital, explained that she approaches diagnosis by excluding the most serious possible conditions first, through questions, investigations and examinations.
This process of elimination allows her to get closer to the “less scary, more age-related diagnosis,” Patel told attendees.
She achieves this by ensuring she is systematic when investigating cases, working “from the eyebrow to the eyelid to the eyeball.”
Oculoplastics is the group of surgical procedures that treat the tear ducts, eyelids, eye sockets and face.
The adnexal service at Moorfields treats tissue surrounding the eyeball, such as the eyelids, extra-ocular muscles, eye socket and tear system.
Patel’s presentation focused on the anatomy of the upper eyelid.
During the presentation, she emphasised the importance of being methodical when making assessments in this area.
Practitioners should work from the anterior lamella to the posterior lamella, she said, analysing the anatomy and function of these structures and how they are being examined.
“Once you’ve got those core skills, it makes understanding disease easier, and in turn makes understanding the management of these diseases easier,” she said.
Patel also gave attendees a demonstration on how she would perform an investigation of the eyelid.
“In people with certain conditions, the lid will be quite far away from the eyeball,” she said.
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