Epidemiology of oculoplastic conditions: the Singapore experience

To study the prevalence of eyelid, lacrimal, orbital conditions in an outpatient and surgical environment in a tertiary care hospital in Singapore.

An 8-month study was conducted in the Oculoplastics Department at the National University Health System (NUHS). Demographic data, diagnosis details and surgical records were compared.

Of 623 patients seen over 906 visits, prevalence was as follows: eyelid (60.3%), orbital (20.6%), lacrimal (16.3%), dysthyroid exophthalmos (6.0%). Sixty-two (10.0%) patients had more than one condition. The most common conditions encountered included blepharoptosis, lacrimal obstruction, and orbital deformities (including fractures). During the same period, distribution of surgical procedures was as follows: eyelid (77.4%), lacrimal (13.1%) and orbit (9.5%). Interestingly, epiblepharon correction comprised 9.5% of the clinical/surgical cases.

Although eyelid related conditions are most common, lacrimal and orbital pathologies cause significant morbidity. Oculoplastics specialists and ophthalmologists should consider placing more emphasis on surgical training specific to such conditions. We also propose separate classifications for epiblepharon and thyroid eye disease in the International Classification of Diseases (ICD) as they are unique clinical problems in their own right. A postoperative status will also help efficiently classify patients as such patients are at risk for related complications subsequently. An examination of healthcare budget allocation for such conditions is also suggested.