Orbital Decompression Surgery (Bulging Eye Surgery)
Eyes can bulge for a few different reasons, though the most common cause is Thyroid Eye Disease. In specific conditions, such as Graves’ Disease, the tissues around the eyes can swell. This can encompass the fat or the muscles around the eyes. In these cases, the eyes may have a variety of side effects caused by the bulging, including irritation of the eyes, double vision, eyelid retraction, and even vision loss. In order to make the eyes more comfortable and treat some of these effects, decompression surgery can be performed to help the eyes return to a more normal position.
My eyes are red and irritated all the time. Is this from bulging?
Bulging of the eyes causes them to be more exposed to the air and environment. The eyelids also don’t do as good a job lubricating the surface of the eyes when the eyes bulge. As a result, dry eye-type symptoms such as redness, irritation and blurring of vision are quite common. As a first step, Dr. Dewan recommends treating these symptoms with artificial tears and other lubricants, but decompression surgery may be the ultimate solution.
What is the surgical experience for decompression?
Orbital decompression surgery is performed in the operating room with you completely asleep. Surgery is performed through an incision on the backside of the lower eyelid and is carried into the skin on the outside corner of the eye. From here, bone is removed from underneath the eye and from the middle wall of the eye socket. Sutures are then placed in the outer corner of the eye to close the incision. If surgery is necessary for both eyes, it is often performed on both sides together. Patients may stay in observation overnight, though some may go home after surgery.
What is the post-operative experience?
Patients are quite swollen and bruised following this surgery. Lots of ice packs and rest are essential. Dr. Dewan typically prescribes a small amount of pain medicine and antibiotic ointment for you to use for the first few days. You may also have a prescription for oral steroids and antibiotics. Your vision may be slightly blurry following surgery, and swelling can cause mild double vision. After 1 week, most of these symptoms are greatly improved and you can return to normal activity.
What if my bulging is being caused by swollen eyelids?
While most patients have bulging caused by Thyroid Eye Disease resulting in the description above, some patients have swelling primarily in the upper eyelids. These patients may not need a full orbital decompression, but rather a fat decompression. This is a type of decompression where fat is removed from the eyelids and from around the eye without the need for bone decompression. Dr. Dewan will evaluate your eyelids and eyes and can provide you with a customized treatment plan.
My eyes are bulging and I’d like to talk to someone. What’s the next step?
Bulging eyes are a complex problem with multiple potential ways to improve them. Dr. Dewan is happy to help you achieve your goals. During your consultation, he will take a thorough history and perform a comprehensive exam to determine the best way to help you. He may recommend additional tests including blood tests and CT scans prior to recommending surgery to ensure you have the best outcome possible. If interested, schedule a consultation today.
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