Procedures offered

Procedures and services offered with Dr. Punja and Dr. Shah.

Lacrimal/tearing:

Lids

Reconstruction

Cosmetic

Retinal

Cosmetic Procedures

BLEPHAROPLASTY – Your eyes are usually the first thing that people notice. Droopy or baggy eyelids may detract from the overall attractiveness of ones eyes, imparting a tired or older appearance of your eyes. Blepharoplasty is a surgical procedure done on the upper and/or lower eyelids to restore a more youthful appearance, and/or allow the eyes to
open further thereby improving vision. This is accomplished by adjusting and/or removing excess skin, muscle and fat tissue. You can look as good as you feel.

BOTOX – Frown lines between the eyebrows, forehead lines and even laugh lines are caused by overactive muscles repeatedly creasing the skin. Botox, a natural, purified protein, is injected into these muscles to relax them, virtually erasing lines and wrinkles. This FDA-approved treatment is safe and effective, and can impart a more youthful appearance.

CHEMICAL PEELS – Chemical peels have been performed for over 100 years to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for individuals with facial blemishes, fine wrinkles and uneven skin pigmentation. All chemical peels use an exfoliating agent and when applied to the skin in a very controlled manner, this tightens the skin and stimulates the growth of new, more youthful and is a blockage of the lacrimal (tear) duct, malposition of the tear duct, and a deficiency in the production and/or composition of tears. A proper diagnosis by a plastic and reconstructive surgeon who specialize in disease and ophtahlmic conditions affecting the eyelids can determine the cause and an appropriate treatment.

EYELID SKIN CANCERS – Eyelid skin cancers occur most often on the lower eyelid, but may be found anywhere on the eyelid margins, corners of the eye, eyebrow skin, or adjacent areas of the face. Usually, they appear as painless elevations or nodules. Excessive exposure to sunlight is the single most important factor associated with skin cancers on the face, eyelids, and arms. The most common types of skin cancers are basal cell carcinoma and squamous cell carcinoma. It is important to know that both are relatively slow growing. Thus, when detected early and treated in a prompt and appropriate manner, there is a better chance of removing the tumor completely and minimizing the amount of tissue affected by the carcinoma.

BLEPHAROSPASM – Blepharospasm is a debilitating disorder of involuntary spasm and is more common in women than in men. Although the cause of blepharospasm is not completely understood, it is thought to be the result of a “miscommunication” in the area(s) of the brain responsible for control of the involved muscles. It is often made worse by stress, fatigue, bright light, watching television, driving, and social interactions. Systemic medications have limited efficacy in treating the disease. Local injection of a medication
called botullinum toxin, which can last two to three months before a retreatment is necessary.

THYROID RELATED EYE DISEASE – Graves’ disease, a condition in which the thyroid gland is hyperactive, may develop at any age and in either sex. Graves’ disease affects the eyes in various ways, they may bulge or appear red and swollen, the space between the lids may widen, can cause excess less sun-damaged skin. This is most commonly performed for cosmetic purposes but may also remove pre-cancerous skin growths, soften acne facial scars and can even control acne. Depending on the severity of the skin damage, the chemical solutions are applied in varying concentrations to alter the superficial, medium or deep layers of the skin. These treatments are generally considered very safe and can be used not only on the face, but on the neck, chest, arms and hands. Anywhere you wish to rejuvenate or improve your skin.

ENDOSCOPIC BROW LIFT & FOREHEAD REJUVENATION – The skin of the forehead stretches and sags over time due to eyebrows, excess skin in the eyelids, and wrinkles around the outer corners of the eyes. These facial changes falsely create an image of exhaustion or anger and leave you feeling fatigue from unconsciously raising the brow. Endoscopic brow lift & forehead rejuvenation elevates eyebrows to their more youthful position reducing excess eyelid skin and crow’s feet. The endoscopic technique uses very small incisions creating minimal scarring and quicker recovery. This approach has enjoyed much greater patient satisfaction then older techniques that often created an undesirable surprised look. Following your procedure, you can expect to look younger and more rested.

MIDFACE CHEEK ELEVATION – One of the earliest signs of aging, both in men and women, is a sagging of the cheek pads as they yield to gravity. Younger patients who are not ready for a full facelift are opting for the rejuvenation of the midface lift. The surgical procedure lifts the cheek pads restoring their natural youthful position without extensive surgery or extended downtime. The cheeks are elevated and the sagging facial features reduced, resulting in a more vibrant, youthful, and natural facial expression. tearing, discomfort, and there may be sensitivity to light, blurring or double vision, inflammation, or decreased eye movement. Although Graves’ disease may affect comfort, vision, or appearance, many of these problems can be treated successfully. Thorough discussions with your physician will help determine an appropriate treatment plan.

ENUCLEATION – Enucleation is a surgical procedure to remove the eyeball from the eye socket.It may be done because of pain, tumor, severe injury, chronic infection, or for cosmetic reasons.

EVISCERATION – Evisceration of the eye is a surgical procedure done to remove the inner contents of the eye, and the cornea (lens). The sclera (white part of the eye) is not removed. This procedure may be done because of a blind, painful, or cosmetically poor eye.

Reconstructive Procedures

UPPER EYELID DROOPING (PTOSIS) – Droopy eyelids occur when the edge of the upper eyelids falls and covers part of the pupil, blocking the upper part of your vision. In most cases, a drooping upper eyelid results from aging. Surgery to repair ptosis is most commonly performed under local anesthesia as an outpatient by ophthalmic plastic and reconstructive surgeons who specialize in disease and conditions affecting the eyelids.

EYELID TURNING IN (ENTROPION) – Entropion is the medical term used to describe rolling inward of the lower eyelid and eyelashes towards the eye. Eyelashes rubbing against the eye can lead to excessive tearing, crusting of the eyelid, mucous discharge, a feeling that something is in the eye, irritation of the cornea, and impaired vision. Most cases of entropion are due to a relaxation of the tissues of the eyelid as a result of aging. The surgery to repair entropion is performed under local anesthesia as an outpatient.

EYELID TURNING OUT (ECTROPION) – An ectropion is an outwardly turned eyelid.  The lower eyelid is nearly always affected. In most cases, the cause is involutional and associated with the aging process.  Normal aging may cause laxity of the small muscle groups that hold the eyelid in place. When the eyelid muscles can no longer keep the lid taut against the eye, it sags, causing dryness and irritation. Repair of ectropion usually requires surgery to tighten the eyelid muscles.

EXCESSIVE TEARING – In order for the eye to remain healthy, it must remain moist. The purpose of normal tears is to lubricate, nourish, and protect the eye. When you blink, your eye-lid spreads the tears over the surface of the eye and pumps excess tears into a “duct” that drains the tears into your nose. The most common causes of excessive tearing.