A trans‑conjunctival approach accesses the orbit or eyelids through incisions in the conjunctiva rather than the skin. It is used for certain fractures, orbital decompressions, and lower lid or orbital surgery.
Advantages
Because incisions are hidden on the inside of the eyelid, external scarring is minimal. The approach provides good access to the orbital floor and rim while preserving skin and lash line.
- Often combined with endoscopic or transcaruncular routes for wider exposure
- Requires careful handling to protect the ocular surface and lid support
- Can be used in cosmetic lower lid blepharoplasty for fat removal
- Post‑operative redness of the conjunctiva generally settles with time
Recovery
Patients may experience temporary swelling, bruising, and foreign‑body sensation. Lubricants and drops support comfort and healing.
- Risk of lid malposition is reduced compared with some transcutaneous approaches but still monitored
- Follow‑up checks lid function, ocular surface, and surgical site
- Ice packs and head elevation help limit swelling in the early days
- Choice of approach depends on pathology, anatomy, and cosmetic priorities
