Oculoplastic Eye Problems
Please click here to view the full Oculoplastic Eye Problems Commissioning Statement.
Oculoplastic procedures are not routinely commissioned as many are for cosmetic reasons. However there are a number of conditions which affect vision and functionality affecting activities of daily living and quality of life which may be considered via IFR for surgical correction.
The following eyelid surgery procedures will NOT be commissioned unless there is any diagnostic uncertainty:
- Removal of eyelid papilloma’s or skin tags
- Surgery for cyst of moll
- Surgery for cyst of zeis
- Surgery for pingueculum
- Excision of other lid lumps
- Excision of other lid lumps
- Surgery for cosmetic reasons
The following conditions are NOT routinely commissioned but there are specified criteria which may be considered by IFR for referral and treatment in secondary care:
Ectropion
Background: Ectropion is a condition, typically a consequence of advanced age, in which the eyelid is turned outwards away from the eyeball.
Policy: Ectropion is not routinely commissioned unless:
- Conservative management has been exhausted and there is evidence of significant impairment of the punctum
- There is recurrent infection in surrounding skin.
Epiphora
Background: Epiphora is an overflow of tears onto the face. A clinical sign or condition that constitutes insufficient tear film drainage from the eyes in that tears will drain down the face rather than through the nasolacrimal system.
Policy: Refer to the IFR Panel for watery eyes surgery when, despite undergoing conservative management, the patient is experiencing a daily impact of significant watering of the eyes indoors and outdoors affecting visual function and / or interfering markedly with quality of life.
Blepharitis
Background: Blepharitis is a common condition where the edges of the eyelids (eyelid margins) become red and swollen (inflamed).
Policy: Referral to secondary care for Blepharitis is NOT routinely commissioned. Refer to IFR if symptoms are persistent and have exhausted antibiotic therapy. If lids persistently swollen consider alternative diagnosis e.g. malignancy and refer under the 2 week referral wait.
To submit an application to the CCG's Individual Funding Request Panel, please click here for further information.
