Orbital Decompression

In order to address exophthalmos (bulging eyes) caused by thyroid eye disease, orbital decompression surgery may be considered. This procedure involves removing bone from the eye socket to alleviate one or more sinuses and to create space made for swollen tissue. This allows the eye to move back into normal position. This surgery is usually performed when the patient’s disease has been stable for at least six months. In some cases, the surgery becomes urgent to prevent blindness from optic nerve compression.

Non-surgical approaches can alleviate symptoms and include lubrication, steroid use, and blepharoplasty. Topical lubrication can be utilized to avoid corneal damage. Corticosteroids can help reduce orbital inflammation, but side effects and extended use are concerns. Blepharoplasty can also be performed to debulk the excess fat in the lower eyelid. Another approach involves quitting cigarette smoking, as it will usually reduce inflammation. Some patients go into spontaneous remission within a year, but these patients should be monitored for thyroid hormone levels by an endocrinologist.

Orbital Decompression Surgery

The bone between the orbit and the sinuses is removed during orbital decompression surgery. Removing the bone between the eye socket and the air spaces next to the orbit improves vision and provides more room for the eye to retract into the orbit.

Orbital Decompression Orbital Anatomy

Thyroid eye disease (Graves’ disease) can result in proptosis, where the eyes bulge due to inflammatory conditions. The bones involved in decompressions surgery include the frontal, maxillary, zygomatic, lacrimal, ethmoid, palatine, and sphenoid. Orbital decompression surgery is undertaken to create more space within the orbit to accommodate enlarged tissues or muscles. Cerebrospinal fluid leakage and infection are potential complications. Optic nerve injury can also result in double visions and lip numbness for several months.