Specific Orbital Services and Surgeries performed by Dr. Cockerham include:
Dr. Cockerham is the local and regional expert for providing treatment for this group of patients. When necessary, she coordinates your care with your endocrinologist, rheumatologist, oncologist, radiation oncologist, and sometimes brain or sinus surgeons as appropriate.
Orbital Tumors
The orbital socket contains the eye muscles, nerves, and the eye. Various tumors may form within or spread to the orbit. Dr. Cockerham is the regional expert in caring for patients with orbital tumors. Although some tumors are not cancerous they still require removal to protect your vision. To determine whether a tumor is cancerous, a biopsy is performed and the tumor is removed to prevent it from spreading to the brain or other vital organs. In the case of cancerous tumors, Dr. Cockerham will work with a comprehensive team consisting of oncologist, radiation oncologist and sometimes brain or sinus surgeons to properly treat the tumor.
Thyroid Associated Orbitopathy
Thyroid Eye Disease is the most common orbital problem treated by Dr. Cockerham. This disease is an autoimmune problem, most commonly noted in patient with a history of either high or low thyroid hormones. Initially the patient will experience redness, swelling and watering of the eye and is referred to as the active and inflammatory phase of the disease. During this early phase patients may benefit from treatments that reduce inflammation such as anti-inflammatory medications or injections and in some cases referral for orbital radiation. In the later part of the disease the eyes may bulge out of the socket, the eyelids may be open too wide, or the patient may have double vision.
Dr. Cockerham is an expert in the surgeries used to correct the bulging eyes and eyelid abnormalities seen in Thyroid Eye Disease. She understands that her patients seek treatment to achieve both the vision and the appearances they had prior to developing Thyroid Eye Disease.
Orbital Trauma
Throughout the United States, injuries to the eyes and eye socket are a common occurrence. Traumatic events may cause eyelid laceration, tear drain injuries, bleeding within and bruising around the eye, or fractures of the bones of the eye socket. Very often these injuries occur because of participation in sporting activities like baseball, soccer or football. Car accidents or fist fights are another major cause of these injuries. If a fracture to the eye orbit occurs it can impact both the form and function of the eye. If the fracture is adjacent to one of the eye muscles, such as in a blow out fracture of the orbit, double vision may occur. Whereas a fractures to the jaw or bones adjacent to the muscles that move the jaw may cause problems chewing.
When trauma to the orbit and eye area happens it may result in bruising and possibly fractures of the orbital bone blowing out into the surrounding sinus. Since the bones of the eye socket don’t move like your arm or leg, they may not need to be treated. However, fractures causing double vision or large fractures that reach into the sinus should be repaired in a timely fashion. Sometimes this is not possible and the late treatment of the injury can still be accomplished.
If the orbital trauma is severe enough to irreparably injure the eye or an eye is diseased and has become blind, painful and disfiguring, the removal of an eye ( or enucleation) may be required. This occurs when the eye cannot be salvaged and the reconstruction of the eye socket to prepare it for a prosthetic eye will need to be performed. This surgery helps to provide a very pleasing result in addition to the benefits of removing the blinded eye or diseased, painful eye. Additionally, an eye socket that has previously had the eye removed may also experience problems and need regular examinations and further reconstruction.
Deformities of the face, such as a sunken looking eye or a flat cheek bone may also occur because of a fracture to the facial bones. Dr. Cockerham is an expert in correcting fractures to the periocular region. Although it is best to operate on these fractures as soon as possible after the injury this may not always be possible. Dr. Cockerham has experience treating both early and late fracture repair.
Dermis fat grafts
A dermal fat graft placed into the lower eyelid can treat milder cases of orbital hollowness. This graft is be inserted into the eyelid itself or used as a "spacer" along the back surface of the lid in cases of eyelid retraction accompanied by hollowness. Employed as a one-piece implant, the graft consists of the skin's dermis with a thin layer of attached subcutaneous fat. When inserted fully into the eyelid, the dermis facilitates the growth of blood vessels into the fat.
The graft can be obtained from any hairless area of skin. The most common donor sites include the flank, waist, and buttocks, as well as skin discarded from a simultaneous face lift. Dermal fat grafting has been used to add volume to the face and body for many years.
Dr. Cockerham is an expert in these techniques and you should discuss with her the method that will give you the best result. To learn more about the treatment of orbital disease or injury, click here to schedule a FREE consultation with Zeiter Eye Medical Group.