DEPARTMENT OF COUNSELLING
Orbit counselling
ARAVIND EYE CARE SYSTEM
Aravind Eye Hospital
& Postgraduate Institute of Ophthalmology
What is Orbit?
 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
7 bones of Orbit
1.
2.
3.
4.
5.
6.
7.
Frontal bone
Sphenoid bone
Zygomatic bone
Maxillary bone
Palatine bone
Ethmoid bone
Lacrimal bone
Orbit picture
Lacrimal Drainage Disorders
 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
Symptoms
1.
2.
3.
4.
5.
Watering
Discharge (mucous or pus)
Severe pain
Swelling
Redness
Investigations
1. Syringing
2. Complete Hemogram (Blood group,
Blood type, Bleeding time, Clotting
Time)
3. Blood Pressure
4. Blood Sugar
5. HIV Test
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