Making more room in the bony socket, so an eye pushed forward by thyroid eye disease can settle back.
What it is
In thyroid eye disease the muscles and fat behind the eye swell, pushing the eye forward. Removing part of the socket wall, or some fat, gives that swelling room and eases the pressure.
The operation
Through cuts hidden in the lid or the corner of the eye, part of the socket wall is removed, and sometimes fat with it.
It takes one to two hours under general anaesthetic, usually with one night in hospital.
What it does not do
It treats the position and pressure, not the thyroid condition itself. Your endocrinologist stays involved.
Who it can help
It may suit you if makes room behind the eye when it is pushed forward is what you notice most, and you are otherwise well.
- Eyes pushed forward, with discomfort or exposure
- Pressure on the nerve at the back of the eye
- Thyroid eye disease that has settled, for appearance
- Difficulty closing the eyes at night
Where sight is threatened, this is done urgently. Otherwise it waits until the disease is stable.
Recovery and risks
This is bigger surgery, and recovery takes longer. Your consultant will explain what to expect in your case.
The first two days
You stay in hospital overnight so the team can check the eye. Swelling and bruising are marked.
The first two weeks
Swelling settles slowly. Avoid blowing your nose, bending and heavy lifting.
Weeks two to six
Bruising fades and vision settles. Double vision, if you have it, usually improves.
Three to six months
The socket has settled. Any further treatment is planned at this point.
Possible risks
Every operation carries some risk. For orbital decompression these include:
- Bruising and swelling that take a few weeks to settle
- Numbness of the cheek or forehead
- Double vision, which is usually temporary
- Bleeding or infection, which are uncommon
- Very rarely, a change in vision
Your surgeon will go through the risks that apply to you, and give you written information to take home.
Insurance
Orbital decompression is sometimes covered when the problem affects your health or your vision. Surgery for appearance alone is not.
Check your cover with your insurer before your consultation, and your surgeon will supply what they need.
Questions patients ask
Will I see double afterwards?
Double vision can appear or change after decompression. It often settles, and squint surgery can correct what remains.
How long in hospital?
Usually one night, so the team can watch the eye overnight.
When can I fly?
Usually after two to four weeks. Ask your surgeon about your own plans.
Is it covered?
Usually yes. This is medical treatment.