Oculoplastics & Orbit

Faculty

Dr. P.J. Dolman, Clinical Professor & Division Head
Dr. F. Buffam, Clinical Professor (emeritus)
Dr J. Carruthers, Clinical Professor
Dr P. Denton, Clinical Assistant Professor
Dr. H. Dhaliwal, Clinical Associate Professor
Dr. C. Pollock, Clinical Instructor
Dr. J. Rootman, Clinical Professor (emeritus)
Dr. D. Rossman, Clinical Assistant Professor
Dr. V.A. Wong, Clinical Professor

Overview

Our division’s goals include excellent clinical care, teaching and research.

Our seven active clinicians manage patients with diseases of the eyelids, lacrimal system and orbit from throughout the province and Western Canada.  Dedicated clinics and surgery are provided in lower mainland teaching hospitals including the Eye Care Centre and the Burnaby, Children’s, Lion’s Gate, Providence, Vancouver General and University Hospitals.  Drs Denton, Dhaliwal, Pollock and Wong focus on oculoplastic diseases, Dr Carruthers on cosmetic oculoplastic procedures and Drs Dolman and Rossman on both oculoplastic and orbit disease.  Our division works collaboratively with other medical departments, including dermatology, endocrinology, oncology, otorhinolaryngology, neurosurgery, pathology, plastic surgery and rheumatology.

Teaching plays an integral role in the division with “hands on” teaching being a major strength for both residents and fellows. More than 1000 hours per year of teaching is provided by the members of the division in both clinical and surgical settings. Oculoplastic and orbit rounds are held for the residents and Fellows every fourth week. The division offers 1-2 fellowship training positions per year lasting 12 months, with special consideration for those returning to underserviced areas or academic programmes. Over 60 fellows from every continent have been trained in our unit over the past 35 years. Our teaching extends to other medical departments, with off-service rotations by plastic surgery and endocrinology residents. Several of our faculty are involved in national and international teaching through visiting professorships and lectures, and in volunteering their time to teach and perform surgery in underserviced areas around the world.  Our members have contributed several well recognized textbooks in oculoplastics and orbital surgery and pathogenesis.

In orbital research, our division has been involved with international collaborators in classifying and managing thyroid eye disease and orbital malignancies.  In oculoplastics, our contributions have included reviews of eyelid malignancies and several prospective studies on endonasal lacrimal surgery as well as extensive work on cosmetic grading scales.  Several clinicopathologic studies have been conducted collaboratively with our Ocular Pathology colleagues.

 

Publications (last 5 years)

Carruthers JA

Carruthers J, Solish N et al. Injectable DaxibotulinumtoxinA for the Treatment of Glabellar Lines: A Phase 2, Randomized, Dose-Ranging, Double-Blind, Multicenter Comparison With OnabotulinumtoxinA and Placebo. Dermatol Surg. 2017 Nov;43(11):1321-1331

Carruthers JD, Humphrey S, Rivers JK. Cryolipolysis for Reduction of Arm Fat: Safety and Efficacy of a Prototype CoolCup Applicator With Flat Contour. Dermatol Surg. 2017 Jul;43(7):940-949

Marr K, Carruthers JDA, Humphrey S. Transient Nerve Damage After Microfocused Ultrasound With Visualization. Dermatol Surg. 2017 Jun;43(6):894-896

Carruthers J, Humphrey S, Beleznay K, Carruthers A. Suggested Injection Zone for Soft Tissue Fillers in the Temple?  Dermatol Surg. 2017 Apr 12

Carruthers J, Humphrey S, Beleznay K, Carruthers A. Suggested Injection Zone for Soft Tissue Fillers in the Temple?  Dermatol Surg. 2017 May;43(5):756-

de Almeida ART, Romiti A, Carruthers JDA.  The Facial Platysma and Its Underappreciated Role in Lower Face Dynamics and Contour. Dermatol Surg. 2017 Aug;43(8):1042-1049

Carruthers J, Coleman K. Special Issue: Deoxycholic Acid Injection Treatment for Reduction of Submental Fat. Dermatol Surg. 2016 Nov;42 Suppl 1:S259

Fabi SG, Burgess C, Carruthers A et al  Consensus Recommendations for Combined Aesthetic Interventions Using Botulinum Toxin, Fillers, and Microfocused Ultrasound in the Neck, Décolletage, Hands, and Other Areas of the Body. Dermatol Surg. 2016 Oct;42(10):1199-1208

Donofrio L, Carruthers J, Hardas B et al.  Development and Validation of a Photonumeric Scale for Evaluation of Infraorbital Hollows.  Dermatol Surg. 2016 Oct;42 Suppl 1:S251-S258.

Carruthers A, Donofrio L et al. Development and Validation of a Photonumeric Scale for Evaluation of Static Horizontal Forehead Lines. Dermatol Surg. 2016 Oct;42 Suppl 1:S243-S250.

Jones D, Carruthers A et al.  Development and Validation of a Photonumeric Scale for Evaluation of Transverse Neck Lines. Dermatol Surg. 2016 Oct;42 Suppl 1:S235-S242.

Carruthers J, Donofrio L et al. Development and Validation of a Photonumeric Scale for Evaluation of Facial Fine Lines.  Dermatol Surg. 2016 Oct;42 Suppl 1:S227-S234.

Donofrio L, Carruthers A et al.  Development and Validation of a Photonumeric Scale for Evaluation of Facial Skin Texture.  Dermatol Surg. 2016 Oct;42 Suppl 1:S219-S226.

Sykes JM, Carruthers A et al.  Development and Validation of a Photonumeric Scale for Assessment of Chin Retrusion.  Dermatol Surg. 2016 Oct;42 Suppl 1:S211-S218.

Carruthers J, Jones D, Hardas B, Murphy DK, Donofrio L, Sykes JM, Carruthers A, Creutz L, Marx A, Dill S.  Development and Validation of a Photonumeric Scale for Evaluation of Volume Deficit of the Temple. Dermatol Surg. 2016 Oct;42 Suppl 1:S203-S210.

Jones D, Donofrio L et al.  Development and Validation of a Photonumeric Scale for Evaluation of Volume Deficit of the Hand.  Dermatol Surg. 2016 Oct;42 Suppl 1:S195-S202.

Carruthers A, Carruthers J. Introduction to Photonumeric Scales Issue. Dermatol Surg. 2016 Oct;42 Suppl 1:S193-S194.

Klassen AF, Cano SJ et al.  FACE-Q Eye Module for Measuring Patient-Reported Outcomes Following Cosmetic Eye Treatments.  JAMA Facial Plast Surg. 2017 Jan 1;19(1):7-14

Carruthers A, Carruthers J, Fagien S, Lei X, Kolodziejczyk J, Brin MF. Repeated OnabotulinumtoxinA Treatment of Glabellar Lines at Rest Over Three Treatment Cycles.  Dermatol Surg. 2016 Sep;42(9):1094-101

Carruthers J, Carruthers A. A Multimodal Approach to Rejuvenation of the Lower Face. Dermatol Surg. 2016 May;42

Sundaram H, Liew S et al   Global Aesthetics Consensus: Hyaluronic Acid Fillers and Botulinum Toxin Type A-Recommendations for Combined Treatment and Optimizing Outcomes in Diverse Patient Populations.  Plast Reconstr Surg. 2016 May;137(5):1410-23

Fabi SG, Carruthers J. Single Modality Approach to Rejuvenate the Aging Face and Body: A Thing of the Past? Dermatol Surg. 2016 May;42 Suppl 2:S73-6

Carruthers J, Beer K, Carruthers A, Coleman WP 3rd, Draelos ZD, Jones D, Goldman MP, Pucci ML, VanDenburgh A, Weng E, Whitcup SM.  Bimatoprost 0.03% for the Treatment of Eyebrow Hypotrichosis. Dermatol Surg. 2016 May;42(5):608-17

Carruthers J, Burgess C et al  Consensus Recommendations for Combined Aesthetic Interventions in the Face Using Botulinum Toxin, Fillers, and Energy-Based Devices. Dermatol Surg. 2016 May;42(5):586-97

Klassen AF, Cano SJ et al.  Development and Psychometric Validation of the FACE-Q Skin, Lips, and Facial Rhytids Appearance Scales and Adverse Effects Checklists for Cosmetic Procedures.  JAMA Dermatol. 2016 Apr;152(4):443-51

Sundaram H, Signorini M et al. Global Aesthetics Consensus: Botulinum Toxin Type A–Evidence-Based Review, Emerging Concepts, and Consensus Recommendations for Aesthetic Use, Including Updates on Complications.  Plast Reconstr Surg. 2016 Mar;137(3):518e-529e.

Vanaman M, Fabi SG, Carruthers J. Complications in the Cosmetic Dermatology Patient: A Review and Our Experience (Part 2). Dermatol Surg. 2016 Jan;42(1):12-20

Vanaman M, Fabi SG, Carruthers J.  Complications in the Cosmetic Dermatology Patient: A Review and Our Experience (Part 1).  Dermatol Surg. 2016 Jan;42(1):1-11.

Jones DH, Carruthers J et al  REFINE-1, a Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial With ATX-101, an Injectable Drug for Submental Fat Reduction.  Dermatol Surg. 2016 Jan;42(1):38-49

Carruthers J, Fagien S, Dolman P.  Retro or PeriBulbar Injection Techniques to Reverse Visual Loss After Filler Injections.  Dermatol Surg. 2015 Dec;41 Suppl 1:S354-7

Sykes JM, Cotofana S et al  Upper Face: Clinical Anatomy and Regional Approaches with Injectable Fillers.  Plast Reconstr Surg. 2015 Nov;136(5 Suppl):204S-218S

Carruthers J, Carruthers A, Humphrey S. Introduction to Fillers.  Plast Reconstr Surg. 2015 Nov;136(5 Suppl):120S-131S

Sneath J, Humphrey S, Carruthers A, Carruthers J. Injecting botulinum toxin at different depths is not effective for the correction of eyebrow asymmetry. Dermatol Surg. 2015 Jan;41 Suppl 1:S82-7

Carruthers A, Carruthers J. You want to inject what? Dermatol Surg. 2015 Jan;41 Suppl 1:S2-8

Trindade de Almeida A, Carruthers J, Cox SE, Goldman MP, Wheeler S, Gallagher CJ. Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years: a retrospective cross-sectional analysis of 4,402 glabellar treatments.  Dermatol Surg. 2015 Jan;41 Suppl 1:S19-2

Carruthers JD, Carruthers JA, Humphrey S. Fillers and neocollagenesis. Dermatol Surg. 2014 Dec;40 Suppl 12:S134-6

Carruthers J, Rzany B et al.   Anatomic Guidelines for volume augmentation of the cheek and infraorbital hollow.   Dermatologic Surgery 2012; 1223-33

Flynn, T.C., Carruthers, A., Carruthers, J., Geister, T.L. et al, “Validated Assessment Scales for the Upper Face” Dermatol Surg, 2012;38: 309-319

Carruthers, J., Flynn, T.C., Geister, T.L., Gortelmeyer, R., et al. and Carruthers. A., “Validated Assessment Scales for the Mid Face”, Dermatol Surg, 2012;38:320-332

Sattler, G., Carruthers, A., Carruthers, J., et al.   Validated Assessment Scale for Neck Volume.    Dermatol Surg 2012;38:343-350

Narins RS, Carruthers J, Flynn TC, et al. Validated assessment scales for the lower face. Dermatol Surg. 2012;38:333-42.

Carruthers, A, Carruthers, J. 2012. Botulinum Toxin: Cosmetic and Medical Uses. Philadelphia: Elsevier.

Carruthers, J, Carruthers, A. 2012. Soft Tissue Augmentation. Philadelphia: Elsevier

Carruthers A, Carruthers J et al.   OnabotulinumtoxinA Treatment of Mild Glabellar Lines in Repose. Dermatol Surg 2010;36:2168–2171

Denton P

Codère F, Denton P, Corona J. Endonasal dacryocystorhinostomy: a modified technique with preservation of the nasal and lacrimal mucosa. Ophthal Plast Reconstr Surg. 2010;26:161-4.

Dolman PJ

Diseases of the Orbit and Ocular Adnexa, Fay A and Dolman PJ, Elsevier, 2017

Gene Expression Profiling and Heterogeneity of Nonspecific Orbital Inflammation Affecting the Lacrimal Gland. Rosenbaum JT, Choi D, Dolman PJ et al.  Gene Expression Profiling and Heterogeneity of Nonspecific Orbital Inflammation Affecting the Lacrimal Gland.   JAMA Ophthalmol. 2017 Sep 21

Zhang Z, Ho S, Yin V, Varas G, Rajak S, Dolman PJ et al.  Multicentred international review of orbital exenteration and reconstruction in oculoplastic and orbit practice.  Br J Ophthalmol. 2017 Aug 26

Chan W, Wilcsek G, Ghabrial R, Goldberg RA, Dolman P, Selva D, Malhotra R.  Pediatric endonasal dacryocystorhinostomy: A multicenter series of 116 cases. Orbit. 2017 Oct;36(5):311-31

Mombaerts I, Bilyk JR, Rose GE, McNab AA, Fay A, Dolman PJ et al; Expert Panel of the Orbital Society. Consensus on Diagnostic Criteria of Idiopathic Orbital Inflammation Using a Modified Delphi Approach. JAMA Ophthalmol. 2017 Jul 1;135(7):769-77

Varas G, Dolman PJ.  Maxillary Sinus Wall Thickening in Silent Sinus Syndrome. JAMA Ophthalmol. 2017 May 11;135(5)

Hamilton SN, Nichol A, Truong P, … Dolman P, Gete E, Ma R. Visual Outcomes and Local Control After Fractionated Stereotactic Radiotherapy for Optic Nerve Sheath Meningioma. Ophthal Plast Reconstr Surg. 2017 Apr 1

Jellema HM, Saeed P, Dolman PJ et al.  Objective and subjective outcomes of strabismus surgery in Graves’ orbitopathy: a prospective multicentre study.  Acta Ophthalmol 2017

Fayers T, Fayers PM, Dolman PJ.  Sensitivity and responsiveness of the patient-reported TED-QOL to rehabilitative surgery in thyroid eye disease.  Orbit. 2016 Dec;35(6):328-334

Fayers T, Dolman PJ.  Bicanalicular Silicone Stents in Endonasal Dacryocystorhinostomy: Results of a Randomized Clinical Trial.  Ophthalmology. 2016 Oct;123(10):2255-9

Davies MJ, Dolman PJ.Levator Muscle Enlargement in thyroid eye disease-related upper eyelid retraction. Ophthal Plast Reconstr Surg. 2016 Jan 22

Carruthers J, Fagien S, Dolman PJ.  Retro or Peribulbar injection techniques to reverse visual loss after filler injections.   Dermatol Surg. 2015 Dec;41 Suppl 1:S354-7

Rosenbaum JT, Choi D, …. Dolman PJ et al, The Role of the Immune Response in the Pathogenesis of Thyroid Eye Disease:  A Reassessment.  PLoS One. 2015 Sep 15;10(9)

Rosenbaum JT, Choi D   … Dolman PJ et al   Orbital pseudotumor can be a localized form of granulomatosis with polyangiitis as revealed by gene expression profiling.  Exp Mol Pathol 2015; 8:99(2): 271-8

Rosenbaum JT, Choi D, … Dolman PJ et al   Fibrosis, gene expression and orbital inflammatory disease, Br J Ophthalmol 2015;

Rosenbaum JT, Choi D, … Dolman PJ et al, Parallel gene expression changes in sarcoidosis involving the lacrimal gland, orbital tissue or blood, JAMA Ophthalmol 2015; 133(7):770-7

Rosenbaum JT, Choi D … Dolman PJ et al. Molecular diagnosis of orbital inflammatory disease, Exp Mol Pathol 2015; 98(2):225-9

Wong AJ, Planck SR, … Dolman PJ  et al.  IgG4 Immunostaining and its implications in Orbital Inflammatory Disease. PLoS One. 2014 Oct 10;9(10):e109847.

Nathoo NA, Rasmussen S, Dolman PJ, Rossman DW.  Periocular mass lesions secondary to dermatologic fillers: report of 3 cases. Can J Ophthalmol. 2014 Oct;49(5):468-72

Shams PN, Rasmussen SL, Dolman PJ.  Adult-onset asthma associated with simultaneous conjunctival, eyelid and orbital xanthogranulomatosis responsive to systemic immunosuppression. Ophthal Plast Reconstr Surg. 2014 May 14.

Al-Salem K, Gibson A, Dolman PJ. Management of congenital lacrimal (anlage) fistula. Br J Ophthalmol. 2014 Oct;98(10):1435-6.

Dolman P.  Managing new antiplatelet and anticoagulant agents in the context of oculoplastic and orbital surgery. Can J Ophthalmol. 2014 Apr;49(2):120

Wei LA, Ramey NA, … Dolman PJ, Lucarelli MJ. Orbital osteoma: clinical features and management options. Ophthal Plast Reconstr Surg. 2014 Mar-Apr;30(2) :168-74

Rath S, Cowan BJ, Dolman PJ.  Cicatricial ectropion in grzybowski type of multiple eruptive keratoacanthomas. Ophthal Plast Reconstr Surg. 2014 Mar-Apr;30(2

Shams PN, Ma R, Pickles T, Rootman J, Dolman PJ.  Reduced risk of compressive optic neuropathy using orbital radiotherapy in patients with active thyroid eye disease. Am J Ophthalmol. 2014 Feb

Rath S, Connors JM, Dolman PJ, Rootman J, Rootman DB, White VA.  Comparison of American Joint Committee on Cancer TNM-based staging system (7th edition) and Ann Arbor classification for predicting outcome in ocular adnexal lymphoma. Orbit. 2014 Feb;33(1):23-8.

Avisar I, McNab AA, Dolman PJ, Patel B, Desousa JL, Selva D, Malhotra R.  Endonasal dacryocystorhinostomy for nasolacrimal duct obstruction in patients with sarcoidosis. Orbit. 2013 Aug;32(4):225-30.

Tsang HH, Dolman PJ, Courtemanche DJ, Rassekh SR, Senger C, Lyons CJ.  Prenatal presentation of fronto-orbital congenital infantile fibrosarcoma: a clinicopathologic report. JAMA Ophthalmol. 2013 Jul;131(7):965-7.

Czyz CN, Dolman PJ.  Ocular duction studies: statistical issues.  Author reply. Ophthalmology. 2013 Jan;120(1):223.

Roefs AM, Waters PJ, Moore GR, Dolman PJ.   Orbicularis oculi muscle biopsies for mitochondrial DNA analysis in suspected mitochondrial myopathy.   Br J Ophthalmol . 2012; 96:1296-9

Dolman PJ, Rath S.   Orbital radiotherapy for thyroid eye disease.   Curr Opin Ophthalmol . 2012; 23:427-32.

Rodriguez RC, Cornock E, White VA, Dolman PJ.   Eyelid blastomycosis in British Columbia. Can J Ophthalmol . 2012; 47

Dolman PJ.   Evaluating Graves’ orbitopathy   Best Pract Res Clin Endocrinol Metab . 2012 Jun;26:229-48. Review.

Dolman PJ:   Assessing thyroid orbitopathy and the role of ITEDS:   chapter in Orbitopatia de Graves (SP), editors: Genol and Toledano), Madrid, 2012

Wiwatwongwana D, Esdaile JM, White VA, Dolman PJ.   Intravenous immunoglobulin for orbital Wegener’s granulomatosis.   Can J Ophthalmol . 2012;47:82-3..

Dolman PJ, Cahill K, Czyz CN, Douglas RS, Elner VM, et al.   Reliability of estimating ductions in thyroid eye disease: an International Thyroid Eye Disease Society multicenter study.   Ophthalmology. 2012 Feb;119(2):382-9.

Rossman D

Nathoo NA, Rasmussen S, Dolman PJ, Rossman DW. Periocular mass lesions secondary to dermatologic fillers: report of 3 cases. Can J Ophthalmol. 2014 Oct;49(5):468-72

Rootman J

Luemsamran P, Rootman J, White VA, Nassiri N, Heran MKS. The role of biopsy in lacrimal gland inflammation: A clinicopathologic study. Orbit. 2017 Dec;36(6):411-418

Rootman DB, Golan S, Pavlovich P, Rootman J.  Postoperative Changes in Strabismus, Ductions, Exophthalmometry, and Eyelid Retraction After Orbital Decompression for Thyroid Orbitopathy. Ophthal Plast Reconstr Surg. 2017 Jul/Aug;33(4):289-293

Jakobiec FA, Syed ZA, Stagner AM, Harris GJ, Rootman J, Yoon MK, Mombaerts I.  Orbital Inflammation in Pregnant Women.  Am J Ophthalmol. 2016 Jun;166:91-102

Al Qahtani ES, Rootman J, Kersey J, Godoy F, Lyons CJ. Clinical Pearls and Management Recommendations for Strabismus due to Thyroid Orbitopathy. Middle East Afr J Ophthalmol. 2015 Jul-Sep;22(3):307-11

Nassiri N, Rootman J, Rootman DB, Goldberg RA.  Orbital lymphaticovenous malformations: Current and future treatments. Surv Ophthalmol. 2015 Sep-Oct;60(5):383-405

Rootman DB, Rootman J, White VA. Comparative histology of orbital, hepatic and subcutaneous cavernous venous malformations. Br J Ophthalmol. 2015 Jan;99(1):138-40

Chee E, Fong KS, Al Jajeh I, Nassiri N, Rootman J. The association of lacrimal gland inflammation with alopecia areata. Orbit. 2015 Feb;34(1):45-50

Rootman DB, Heran MK, Rootman J, White VA, Luemsamran P, Yucel YH. Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature. Br J Ophthalmol. 2014 Jul;98(7):880-8.

Heran MK, Rootman J, Sangha BS, Yeo JM.  Dynamic arterial and valsalva-augmented venous phase multidetector CT for orbital vascular lesions: a pictorial review.  Ophthal Plast Reconstr Surg. 2014 Mar-Apr;30(2):180-5

Rootman J, Heran MK, Graeb DA.  Vascular malformations of the orbit: classification and the role of imaging in diagnosis and treatment strategies.  Ophthal Plast Reconstr Surg. 2014 Mar-Apr;30(2):91-104.

Reduced risk of compressive optic neuropathy using orbital radiotherapy in patients with active thyroid eye disease.  Shams PN, Ma R, Pickles T, Rootman J, Dolman PJ.  Vascular malformations of the orbit: classification and the role of imaging in diagnosis and treatment strategies.  Am J Ophthalmol. 2014 Jun;157(6):1299-305

Spicer GJ, Kazim M et al. Accuracy of MRI in defining tumor-free margin in optic nerve glioma surgery. Ophthal Plast Reconstr Surg. 2013 Jul-Aug;29(4):277-80

Tan B, Rootman J, Seah LL. Combined radiological intervention and surgical excision of a periorbital arteriovenous fistula.  Orbit. 2013 Jun;32(3):181-3

Sangha BS, Rootman J, Heran MK. CT-guided microcoil localization before surgical management of an intraorbital abscess. J Vasc Interv Radiol. 2012 Sep;23(9):1248-9

Weis E, Heran MK, Jhamb A, Chan AK, Chiu JP, Hurley MC, Rootman J.  Quantitative computed tomographic predictors of compressive optic neuropathy in patients with thyroid orbitopathy: a volumetric analysis.  Ophthalmology. 2012 Oct;119(10):2174-8

Winn BJ, Rootman J. Sclerosing orbital inflammation and systemic disease  Ophthal Plast Reconstr Surg. 2012 Mar-Apr;28(2):107-18

Rootman DB, Rootman J, Gregory S, Feldman KA, Ma R.  Stereotactic fractionated radiotherapy for cavernous venous malformations (hemangioma) of the orbit. Ophthal Plast Reconstr Surg. 2012 Mar-Apr;28(2):96-10

Wong VA

Pfeffer G, Waters PJ, Maguire J, Vallance HD, Wong VA et al.   Levator palpebrae biopsy and diagnosis of progressive external ophthalmoplegia. Can J Neurol Sci . 2012 Jul;39(4):520-4.