Orbital decompression is surgery that creates more space within the eye socket to relieve pressure on the eyes, most often for thyroid eye disease with bulging eyes.
Why orbital decompression is considered
In thyroid eye disease, swollen tissues and fat behind the eyes can push the eyes forward, causing bulging, exposure, and sometimes double vision or optic nerve compression. Decompression removes bone and sometimes fat so the eye can sit further back and the pressure is reduced.
- Can protect sight when the optic nerve is threatened
- Helps lids close more fully to improve comfort and dryness
- May improve appearance by reducing prominence of the eyes
- Often planned once the disease has become stable or “burnt out”
What surgery and recovery involve
The surgeon usually operates through hidden incisions inside the eyelids or sinuses, occasionally using small skin cuts where needed. Bone between the orbit and nearby sinuses is removed, and fat may be trimmed so tissues can expand into new space.
- Swelling, bruising, and some temporary numbness are common afterwards
- Double vision can change, sometimes improving or occasionally worsening
- Several days off work and help at home are often needed initially
- Further eyelid or squint surgery may be staged later for the best outcome
