Some of the conditions that Dr. Goldberg treats:
Basal Cell Carcinoma (BCC): Basal cell carcinoma is the most common kind of skin cancer and the most common eyelid skin cancer. It occurs on the sun-exposed parts of the body, particularly on the head and neck, including the eyelids. BCCs arise as a result of long-term sun exposure. Dr. Goldberg removes eyelid skin cancers and does surgery to reconstruct the eyelid following the cancer excision. Many patients with eyelid skin cancer are treated using a team approach working with dermatologic surgeons who specialize in skin cancer removal called Mohs surgery. The Mohs surgeon removes the skin cancer and examines the tissue to be certain that the skin cancer has been excised completely. If needed, Dr. Goldberg will reconstruct the eyelid following excision of the skin cancer by the Mohs surgeon. Most eyelid reconstruction procedures can be done in the office with local anesthesia.
Blepharoptosis, or Ptosis: Ptosis usually refers to drooping of the upper eyelids, causing obstruction in vision particularly when reading, driving, watching TV, and when tired. It may occur due to aging, or occasionally from a neurological or neuromuscular disorder. Ptosis is usually acquired in adults, but may be a congenital. Surgery recommended is ptosis repair which is done to correct obstruction of vision due to the drooping eyelid. It is medically necessary when there is significant obstruction of the visual field.
Dermatochalasis: Dermatochalasis is an excess amount of eyelid skin. Surgery done to correct dermatochalasis is known as blepharoplasty. Blepharoplasty may be done to correct restricted upper vision, in which case it may be considered to be medically necessary. This is functional blepharoplasty. Blepharoplasty done as an aesthetic procedure is considered a cosmetic procedure.
Chalazion: Chalazia are lumps that occur in the eyelid due to chronic inflammation of an oil gland in the eyelid. A chalazia is a chronic form of stye. They may persist for weeks to months. Chalazia typically are not particularly painful, but they can be reddened and wax and wane in size. They may resolve spontaneously or with prescribed eye drops and warm compresses if treated early. Hordeolums are acute styes. Chalazia that do not resolve may be removed in the office with a brief procedure.
Eyelid Growths/Lesions: Eyelid growths or lesions may be removed for several reasons. They may irritate the eye, itch, bleed, be growing progressively, be pigmented, are cosmetically unacceptable or may be suspicious for skin cancer. Removal is done as a brief office procedure. For diagnostic purposes the removed tissue may be sent to a pathology laboratory. If skin cancer is suspected, a biopsy will be performed with definitive treatment pending the pathology report of the biopsy.
Entropion: Entropion, occurring more often to the lower eyelid than upper eyelid, can be very uncomfortable because the eyelashes rub against and scratch the cornea. This is usually acquired due to aging but may occur from scarring due to trauma or prior surgery. There is a congenital form of entropion that may be called epiblepharon. Symptoms of entropion are redness, irritation, burning, foreign-body sensation (feeling like there is something in the eye), or pain. There may be tearing, discharge, and light sensitivity.
Ectropion: Ectropion is when an eyelid turns out or away from the eye. There may be a gap between the eye and the inside of the eyelid. Ectropion may be unilateral or bilateral. This may be associated with aging, or acquired due to scarring following trauma or prior surgery. It can be associated with facial nerve (Bell’s) palsy. Ectropion can cause redness of the inside lining (conjunctiva) of the eyelid, reddening of the eye, tearing, and mattering.
Blind, painful eye: Surgery to remove an eye is called enucleation. This is done when all other treatment options have failed. The most common indication for enucleation is when the eye is blind and painful which can occur as a result of devastating injury or disease.
Tearing/Epiphora: Excessive tearing of the eye is known as epiphora. Excessive tearing may occur for a variety of reason. It can be due to allergies, a problem with the surface of the eye, dry eye syndrome, a problem with the position or function of the eyelids, or due to poor or absent drainage of tears through the tear duct.
Nasal Lacrimal Duct Obstruction (NLDO): Blocked tear duct. The surface of the eye needs to be wet to be healthy and for the vision to be clear. Tears are produced by the tear (lacrimal) glands. When the eye blinks the surface of the eye is bathed with tears which then drain through the nasal lacrimal or tear duct into the nose. If the tear duct is obstructed or does not drain the tears effectively, the tears will overflow. In addition to excessive tearing, there may be mattering and discharge associated with a blocked tear duct. When NLDO is diagnosed, a surgical procedure called a Dacryocystorhinostomy (DCR) may be recommended. DCR is performed in an outpatient operating room under anesthesia. DCR re-establishes the flow of tears into the nose. (DCR Post-Op Instructions) Some babies are born with blocked tear ducts (congenital nasal lacrimal duct obstruction). Most congenital nasal lacrimal duct obstructions resolve during the first year. If not, nasal lacrimal duct probing or silicone intubation procedures may be done to open the tear duct.
Dacryocystitis: An infection of the lacrimal sac (a part of the tear duct) is a complication of nasal lacrimal duct obstruction. Dacryocystitis causes pressure, pain, redness, and swelling in the inner corner of the eye next to the nose. There may be a lump, severe pain, tearing, and/or discharge from the eye. In acute dacryocystitis the lacrimal sac is abscessed, like a boil. Infection can spread throughout the eyelids. In chronic dacryocystitis there is a tender or painless lump in the corner of the eye adjacent to the nose.
Some of the Procedures that Dr. Goldberg does: