EYELID & OCULOPLASTIC SERVICES
What does an oculoplastic surgeon do?
Our oculoplastic surgeon (also known as an ocular plastic surgeon) specializes in eyelid and facial plastic surgery. Eye plastic surgery can address a variety of conditions such as Graves, orbital fractures, ptosis of the eyelid, congenital malformations and tumors, and disorders of the tear ducts. Learn more about our eyelid and oculoplastic services below!
Tired of looking tired?
The loose skin over your eyes and the bags under your eyes can make you look more tired and older than you really feel. As you age, your eyelid skin can stretch, your muscles weaken and the fat accumulates around your eyes. Blepharoplasty (eyelid surgery) helps eliminate droopy eyelid skin, making you look younger and more alert.
How Eyelid Surgery is Performed
Blepharoplasty can be performed using a local anesthetic. We place fine incisions in the crease of the upper eyelids and remove the excess skin. A laser is often used to speed the recovery. To eliminate lower lid bags, the surgery is performed through the inside of the lower eyelid to hide the incisions. The procedure, depending on the complexity, usually takes about 15-30 minutes.
Your medical insurance may cover an upper eyelid blepharoplasty. We would need to perform a special test to determine if you meet your insurance criteria.
Blepharospasm (also known as benign essential blepharospasm or hemifacial spasm) is an abnormal, involuntary blinking or spasm of the eyelids associated with an abnormal function of the basal ganglion from an unknown cause. The basal ganglion is the part of the brain responsible for controlling eye muscles. In rare cases, heredity may play a role in the development of blepharospasm.
Causes of Blepharospasm
Most people develop blepharospasm without any warning symptoms. It may begin with:
- A gradual increase in blinking or eye irritation
- Emotional tension
- Sensitivity to bright light
As the condition progresses, the symptoms become more frequent and facial spasms may develop. Blepharospasm may decrease or cease while a person is sleeping or concentrating on a specific task.
Treatment for Blepharospasm
BOTOX is a treatment frequently used to reduce facial spasms. When strategically injected into specific muscles, it can relax the eyelid muscles and reduce eyelid twitching.
BOTOX® for Facial Spasms
BOTOX® is also a treatment frequently used to reduce blepharospasms, eyelid twitching, and hemifacial spasms. BOTOX® is delivered by strategically placing injections in the affected muscles. BOTOX® is a toxin produced by the same bacteria responsible for botulism. However, when very small amounts of the toxin are injected into the eyelid muscles it is proven to be safe and effective. The effectiveness is temporary; therefore periodic injections may be necessary.
If you are experiencing excessive tearing, you may have a tear duct obstruction. Tear duct surgery can address the issue. An ocular plastic surgeon uses reconstructive elements of eye plastic surgery to improve the tear drainage system.
How Tears Work
Tears normally drain into the puncta (the small holes located on the inside corners of the upper and lower eyelids). Tears collect in the tear sac that lies under the skin between the corner of the eye and the nose. The tears then flow through a small tube, called the nasolacrimal duct, into the nose. The tears are pumped through this drainage system by the blinking of the eye.
Treatment for Tear Blockage
A blockage anywhere in the drainage system can prevent proper drainage of tears and lead to excess tearing. If there is a blockage in your tear system, an ocular plastic surgeon may perform a dacryocystorhinostomy (DCR). A small incision is placed on the side of the nose. A small hole is then created in the paper-thin bone, and a small, temporary tube is placed from the inside corner of the eye into the nose. The tube is used as a stent in the tear drainage system to prevent scarring. The tube is easily removed in the office approximately three months postoperatively.
Ptosis is usually caused by stretching or thinning of the tendon between the muscle that raises the eyelid and the eyelid itself. With stretching or thinning, the muscle that normally raises the eyelid has to work harder to lift it. This leads to symptoms of eyelid and forehead muscle fatigue and eyelid heaviness. Other, less common causes of ptosis are nerve or muscle damage from any cause, various types of eyelid surgery, infection, muscle weakness, and systemic diseases such as stroke and tumors behind the eye, myasthenia, hypertension, thyroid disorders and diabetes. Children can be born with congenital ptosis; the muscle is abnormally stiff and does not function well. This condition usually lasts until it is surgically corrected.
How is Ptosis corrected?
To correct ptosis, the surgeon needs to make an incision or cut the skin of the upper eyelid in order to reach the muscles and tendons. The surgeon chooses where to make the incision based upon what treatment the eyelid needs. With the front or anterior approach, the surgeon makes an incision in the skin in the upper eyelid crease or fold in order to reach the muscle and tendon; if there is no eyelid fold, one can be created when the incision is made.
About Dr. Blake Perry
Oculofacial Plastic and Reconstructive Surgeon
Dr. Blake Perry grew up in San Diego, California before moving cross country to the East Coast to become an Ivy Leaguer. He attended Princeton University, where he also played football and accumulated several awards, including: The Harland “Pink” Baker Award in 2000 for the freshman defensive player of the year; The Dr. Harry Roemer McPhee Trophy, the school’s outstanding player award, in 2003; and the prestigious All-Ivy Football Selection in both 2002 and 2003. Dr. Perry also demonstrated academic excellence during his time at Princeton, graduating with honors with a bachelor’s in political science. After earning his medical degree from the George Washington University School of Medicine, he completed his ophthalmology residency at one of the nation’s top programs, the University of Iowa. Following residency, he received the elite opportunity to pursue training in Oculofacial Plastic and Reconstructive Surgery via a two-year fellowship sponsored by the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) at Oregon Health & Science University in Portland, Oregon. After fellowship, Dr. Perry returned to Southern California to practice ophthalmology and oculoplastic surgery before relocating to the beautiful Pacific Northwest. He joined the Clarus Eye Centre team in 2018.
Dr. Perry specializes in aesthetic plastic and reconstructive surgery of the face, eyelids, orbit, and lacrimal system. His training makes him an expert at performing facial plastic and reconstructive surgery, as well as addressing issues (like tearing management) that require an in-depth understanding of how to care for the delicate tissues and structures that surround the eye, such as the tear ducts and orbit. Dr. Blake Perry is certified by the American Board of Ophthalmology and is a fellow of ASOPRS. He is a member of the American Academy of Ophthalmology and the Alpha Omega Alpha Honor Medical Society. He has also served as a leader of the medical community on the Board of Trustees for Pierce County Medical Society since 2019.
For leisure, Dr. Perry enjoys spending time with his wife, Shawmonee, and their four kids, which includes coaching his children’s athletic teams, anything related to the outdoors, and sports, such as tennis, basketball, golf, and hiking.