Hooded eyelids w Dr Sid Ogra.

Dr. Louise Kuegler and Dr. Sid Ogra discuss the clinical presentation, implications, and management of hooded eyelids. They explore the functional and cosmetic concerns associated with this condition, emphasising the importance of proper assessment and referral pathways. Dr. Ogra shares insights on the surgical options available, the criteria for referral, and the long-term outcomes and patient satisfaction associated with eyelid surgery. The conversation highlights the often-overlooked functional component of hooded eyelids and the need for primary care physicians to recognise and address these issues.

Practical clinical pearls:

Ask about function, not just appearance. Patients may present for cosmetic reasons, but targeted questions about visual fields, eye strain, or difficulty with reading/driving often reveal functional impairment.

(Function is more commonly impaired than you think and most patients with this issue present for functional reasons)

Use simple examination tools. A visual field test, photographs, or even observing brow elevation can help demonstrate functional impact in primary care before referral.

(All important markers of functional impact are easy to diagnose without special equipment)

Document carefully. Insurers and specialists often require evidence of functional impact (e.g., reduced visual fields, visual obstruction) — clear notes and photos can strengthen a referral.

Blepharoplasty has evidence-based benefits. Beyond cosmesis, studies show improvement in visual fields and patient-reported outcomes — it can be both functionally effective and cost-effective when appropriately indicated.

Know your referral pathways. Many specialties perform this surgery, but referral for functional assessment should occur when there is any concern about impairment or underlying eye pathology.

Guest bio:

Dr Sid Ogra. MBChB, FRANZCO. Specialist in eyelid and tear duct disorders (Oculoplastics) – in adults and children. Specialist in Cataract surgery including premium lenses and correction options:

• Oculoplastic Fellowship, Hereford, UK 2019
• Observerships in Stanford (USA), and Seoul (South Korea)

Sid is a well-established adult and paediatric eyelid specialist and also has a busy cataract surgery practice. He is also servicing Queenstown as well as most regions in Auckland.

After graduating medical school (with distinction) in Auckland, Sid knew that Ophthalmology was the right fit for him. He completed his Ophthalmology training in Auckland, Rotorua, and Wellington, and was able to travel to the UK to further refine his skills in Oculoplastic surgery. Further experience followed at the prestigious Byers Eye Institute in Stanford, USA, as well as Samsung Medical Centre in Seoul, South Korea.

He has a strong belief that doctors and patients must work together as a team to achieve the best results. This means empowering his patients with all the relevant knowledge, discussing the options, and coming to a decision together regarding the best fit for them.

Resources:

Domela Nieuwenhuis, I., Luong, K. P., Vissers, L. C. M., Hummelink, S., Slijper, H. P., & Ulrich, D. J. O. (2022). Assessment of Patient Satisfaction With Appearance, Psychological Well-being, and Aging Appraisal After Upper Blepharoplasty: A Multicenter Prospective Cohort Study. Aesthetic Surgery Journal, 42(4), 340–348. https://doi.org/10.1093/asj/sjab389

An, S. H., Jin, S. W., Kwon, Y. H., Ryu, W. Y., Jeong, W. J., & Ahn, H. B. (2016).

Effects of upper lid blepharoplasty on visual quality in patients with lash ptosis and dermatochalasis. International Journal of Ophthalmology, 9(9), 1320–1324. https://doi.org/10.18240/ijo.2016.09.15

Email me:

thespecialistgp@outlook.co.nz

Listen Here:

Apple: https://podcasts.apple.com/nz/podcast/hooded-eyelids-w-dr-sig-ogra/id1845748299?i=1000747579880

Or wherever you get your podcasts.

#HoodedEyelids #Dermatochalasis #FunctionalEyelids #Ophthalmology #OculoplasticSurgery #Blepharoplasty