Restore healthy vision, comfort, and facial function with expert pediatric oculoplastic care. Dr. David Isaacs, our expert dual-fellowship trained oculofacial plastic surgeon, specializes in treating blocked tear ducts, droopy eyelids (ptosis), epiblepharon, and pediatric eye tumors. His minimally invasive techniques prioritize your child’s long-term development while ensuring natural-looking results in a safe, compassionate environment.
Treat Congenital Eye-Related
Conditions Precisely
Pediatric oculoplastic surgery is a specialized field focused on treating conditions that affect a child’s eyelids, tear ducts, and eye sockets. These conditions often involve both functional and developmental concerns and require careful attention to the child’s facial growth and vision development. Common pediatric issues include droopy eyelids (ptosis), eyelid malpositions, and tumors in the orbit or eyelids.
Dr. David Isaacs is a dual-fellowship trained oculofacial plastic surgeon who specializes in congenital and pediatric oculoplastic care. With extensive experience treating children at Mattel Children’s Hospital at UCLA and Cedars-Sinai, he offers custom solutions using advanced surgical techniques. Dr. Isaacs also teaches pediatric oculoplastic surgery internationally, ensuring his patients receive the highest level of world-class care.
Congenital Nasolacrimal Duct Obstruction (NLDO)
Congenital nasolacrimal duct obstruction (NLDO), also known as a blocked tear duct, occurs when a baby’s tear drainage system fails to fully open at birth. This results in constant tearing, mucous buildup, and recurrent eye infections. While many cases resolve naturally within the first year, persistent blockages can lead to chronic inflammation, discomfort, and, in more severe cases, long-term complications. Early recognition and timely intervention are crucial.
Symptoms of NLDO:
- Constant tearing and watery eyes (even when not crying)
- Mucous discharge or crusting along the eyelashes
- Recurrent eye infections (dacryocystitis)
- Redness or swelling near the inner corner of the eye
Dr. Isaacs’ Approach to Treating a Blocked Tear Duct
Dr. Isaacs employs a progressive strategy tailored to your child’s age and symptoms. For infants under one year old, he recommends conservative care using Crigler massage, warm compresses, and antibiotic drops. If the duct remains blocked beyond 12 months, he may offer an outpatient probing and irrigation procedure to open the tear duct. In rare, complex cases, he performs a scar-free endoscopic dacryocystorhinostomy (DCR) without external incisions. His goal is always to relieve symptoms while supporting natural development.
Congenital Ptosis
Congenital ptosis is a condition present at birth in which one or both upper eyelids droop due to an underdeveloped or weak levator muscle, the muscle responsible for lifting the eyelid. When the drooping eyelid covers the pupil, it can interfere with normal vision development and lead to amblyopia (lazy eye) if left untreated. Children may also develop compensatory habits, such as tilting their head back or raising their eyebrows, to improve their vision.
Symptoms of Congenital Ptosis:
- One or both upper eyelids appear lower than normal
- Constant head tilt or chin-up posture to see
- Frequent eyebrow-raising to compensate for drooping
- Uneven or reduced visual development in the affected eye
- Asymmetry of the eyelids noticeable in photos
Dr. Isaacs’ Approach to Treating Congenital Ptosis
Dr. Isaacs offers specialized, muscle-preserving solutions for congenital ptosis. His preferred technique, supramax levator advancement, repositions the child’s existing levator muscle to achieve natural eyelid movement without implants. For children with extremely weak muscles, he offers a Gore-Tex sling, a synthetic suspension that enhances eyelid elevation while preserving blinking ability. In severe cases, Dr. Isaacs performs a temporalis fascia sling, using the child’s own tissue to create a natural, integrated lift.
Epiblepharon
Epiblepharon is a congenital eyelid condition most commonly seen in Asian and Hispanic children, in which an extra fold of skin causes the eyelashes to turn inward and brush against the surface of the eye. While the eyelid may be normal, the abnormal lash direction can lead to persistent tearing and discomfort. If left untreated, the constant irritation may result in corneal damage and visual disturbances.
Symptoms of Epiblepharon:
- Excessive tearing or watery eyes
- Redness or irritation in the inner corners of the eyes
- Frequent eye rubbing or blinking
- Sensitivity to light
- Eyelashes visibly turned inward against the eye surface
Dr. Isaacs’ Approach to Treating Epiblepharon
Dr. Isaacs offers a minimally invasive solution for epiblepharon that restores eyelash alignment while preserving the child’s eyelid contour. His surgical technique involves a subtle adjustment to the eyelid’s skin and muscle, allowing the lashes to rotate outward and away from the eye. This helps avoid visible scarring and is typically performed using hidden incisions within the natural eyelid crease. Dr. Isaacs customizes each correction to the child’s facial anatomy.
Pediatric Orbital & Eyelid Tumors
Pediatric orbital and eyelid tumors can be benign or malignant and may affect a child’s vision, eye movement, or development. Common benign tumors include dermoid cysts, hemangiomas (blood vessel tumors), and, less commonly, malignant tumors like rhabdomyosarcoma. Early evaluation is crucial for determining the nature of the tumor and preventing complications.
Symptoms of Pediatric Orbital & Eyelid Tumors:
- Noticeable lump or mass in or around the eyelid
- Bulging of one eye (proptosis)
- Drooping eyelid or changes in eye shape
- Redness, swelling, or discoloration
- Vision changes or restricted eye movement
Dr. Isaacs’ Approach to Treating Pediatric Orbital & Eyelid Tumors
For benign lesions such as dermoids or hemangiomas, Dr. Isaacs may use precise, minimally invasive surgical techniques to relieve pressure and restore function. When treating malignant tumors, Dr. Isaacs collaborates with pediatric oncologists and subspecialists for comprehensive, multidisciplinary care. As a dual-fellowship trained oculofacial surgeon with advanced training in orbital surgery, Dr. Isaacs ensures each child receives a personalized treatment plan.
Schedule Your Consultation
David Isaacs, MD, is a dual-fellowship trained oculofacial plastic surgeon specializing in congenital and pediatric oculoplastic surgery. Known for his meticulous, minimally invasive techniques, Dr. Isaacs customizes each treatment to support your child’s development and facial anatomy, using hidden incisions whenever possible. As a UCLA instructor and former Assistant Professor at Loma Linda, he trains surgeons worldwide in pediatric surgeries. Schedule your consultation for expert pediatric oculoplastic care in Beverly Hills today.
