Early Times Report
JAMMU, Oct 16: Today, ophthalmic surgery extends well beyond the eyeball itself. When the eye or the structures surrounding it are affected by disease, injury or a congenital abnormality, the consequences can extend far beyond loss of sight. Modern ophthalmology now offers a range of specialized surgical procedures that can restore function, reconstruct damaged tissues and, in many cases, recreate a natural and harmonious appearance.
Extraocular and reconstructive surgery becomes particularly challenging when patients are born with abnormalities of the eyelids, orbit or eye. These conditions may range from relatively common eyelid abnormalities to extremely rare congenital disorders.
One such rare condition is cryptophthalmos, in which the eyelids fail to develop normally, and the skin extends over and covers part or, in severe cases, most of the eye. Because the eyelids, ocular surface and underlying structures may all be affected, management requires careful assessment and individualized surgical planning.
AIIMS Jammu has successfully performed reconstructive eye surgery in a 5-month-old child with major developmental anomalies, including cryptophthalmos and genitourinary abnormalities. The child initially presented at AIIMS Jammu and was diagnosed with Fraser syndrome. After detailed examination, the child was found to have a rectovesical fistula and cryptophthalmos.
The Paediatric Surgery team led by Dr Lucky Gupta, Associate Professor, successfully performed primary sagittal rectoplasty for rectovesical fistula in a single sitting, instead of a staged procedure.
The child then underwent bilateral eyelid reconstructive surgery with the aim of improving ocular and facial appearance while providing appropriate anatomical coverage and protection. This complex surgery was led by Dr Nazia Anjum, Associate Professor, who caters to extraocular and orbital reconstructive surgery. She was assisted by Dr Shefali Verma, Senior Resident, and a team of junior residents. Under the expert supervision of Dr Nitin Kumar, Additional Professor, and the valuable guidance of Dr Bhavani Raina, Officiating Head, Department of Ophthalmology, the team carried out this rare surgery.
Such cases illustrate the role of specialized ophthalmic reconstructive surgery in conditions where conventional treatment approaches may not be sufficient. They also demonstrate that even rare and complex congenital disorders can be approached with both functional and aesthetic goals in mind.
Successful ocular reconstruction is rarely about a single procedure. These cases are managed through staged reconstruction. Each patient therefore needs an individual treatment plan based on age, ocular health, anatomy, underlying disease and the desired functional and cosmetic outcome," said Dr Nazia Anjum, Associate Professor, AIIMS Jammu.
The critical anesthesia support during the procedure was provided by Dr Shruti Sharma, Dr Raksha Kundal, Dr Salomi Gupta and Dr Aleesha, whose expertise ensured patient safety throughout the surgical procedure.
Prof. (Dr.) Sanjeev Sinha, Executive Director & CEO, AIIMS Jammu, said, "This case highlights the capability of AIIMS Jammu to manage rare and complex congenital conditions through multidisciplinary expertise, meticulous surgical planning and precision. Our institution remains committed to providing advanced, specialized and patient-centred care in the region, ensuring that patients have access to complex treatments closer to home."
The need for reconstructive eye surgery is not limited to congenital conditions. Road traffic accidents, occupational injuries and other forms of facial trauma can severely damage the eyelids, orbit and surrounding tissues. In such circumstances, timely and appropriate reconstruction can be crucial for preserving ocular function and minimizing long-term deformity.
Advances in microsurgical techniques, imaging, implants and prosthetic materials have considerably expanded the possibilities of reconstruction. What was once considered an irreversible cosmetic deformity may today be amenable to sophisticated surgical and prosthetic rehabilitation. |
