Rare Eyelid Disorder Treated with Complex Orbicularis Myectomy Surgery at Gleneagles Hospital Chennai

Chennai: Gleneagles Hospital Chennai has successfully treated a complex case involving one of the rarest eye disorders - Benign Essential Blepharospasm (BEB) combined with the even rarer Apraxia of Eyelid Opening (ALO).

The surgery, performed by Dr. Ravindra Mohan, an experienced Oculoplastic Surgeon at the hospital, has helped a retired Indian Forest Service officer from Jaipur regain his independence after enduring years of frustration and despair.

The patient, who had once led an active and athletic lifestyle, found himself unable to perform basic tasks such as walking outdoors or climbing stairs due to uncontrollable eyelid spasms and the inability to open his eyes. Despite visiting over a dozen hospitals and consulting various specialists across India, he found no lasting relief from treatments, including botulinum toxin injections and even surgery.

"This case is one of the most complex clinical challenges I've encountered in my three decades of specialized work in eyelid surgery. BEB causes uncontrollable eyelid spasms, while ALO results in the freezing of eyelids. Treating both conditions together required a highly customized surgical approach," explained Dr. Ravindra Mohan.

After consulting with an eye surgeon friend in Jaipur, the patient and his wife decided to visit Dr. Mohan in Chennai. During the consultation, Dr. Mohan identified the rare combination of BEB and ALO, which had likely been missed by previous specialists. The coexistence of these two conditions presented a unique challenge for traditional treatments.

The four-hour surgery, performed under general anaesthesia, involved a bilateral orbicularis myectomy to remove the muscles responsible for eyelid spasms. Dr. Mohan also employed an innovative technique to treat ALO by inserting silicon rods as slings, connecting the upper eyelids to the forehead muscles. This allowed the patient to regain control over his eyelids by raising his eyebrows.

“Precision and innovation were key to this dual approach. While the myectomy resolved the spasms, the sling technique allowed the patient to manage ALO. We ensured the levator palpebrae superioris muscles were preserved to maintain natural eyelid closure,” Dr. Mohan elaborated.

The surgery was a success, with the patient experiencing steady recovery. Within weeks, he was able to resume activities he once thought impossible. His regained confidence even led him to consider travelling independently for follow-up visits, although his wife persuaded him to travel with her.

"This case is a testament to the resilience of patients and the power of collaboration between advanced surgical expertise and a dedicated support team," said Dr. Nageswar Rao, CEO of Gleneagles Hospital Chennai. "We are proud of our doctors who led the surgical and post-operative care teams. Identifying and offering the right solution to the problem that the patient faced for years proves our hospital's multidisciplinary collaboration. Every member played a critical role in achieving this success."

“We continue to set benchmarks in advanced medical care, particularly for rare and complex disorders. This landmark surgery underscores the institution’s unwavering dedication to innovation and patient-centric care, offering hope to individuals nationwide,” Dr. Rao added.

"For years, my condition left me helpless and isolated. Even simple activities like playing games or climbing stairs were impossible. Thanks to Dr. Mohan, and his incredible team, I have regained my independence and confidence. I cannot express how grateful I am for their unwavering dedication," said the patient.

His wife, who stood by him every step of the way, shared how the surgery had transformed their lives. "This surgery has brought us a newfound sense of hope and joy," she said.