ORBITAL DECOMPRESSION SURGERY

  • Treats proptosis (bulging eyes) by removing bone and/or fat.
  • Increases space for eye muscles/tissue, reducing proptosis.

Types of surgery

  •  Lateral wall decompression: Incision in outer eyelids, bone removal.
  • - Medial (inner) wall decompression: Incision behind inner corner of eyelids or
    through the nose.
  • Orbital floor decompression: Floor portion removal via lateral or medial wall
    approach.
  • Balanced two-and-a-half wall decompression: Combines medial and lateral walls
    and orbital floor.
  • Fat decompression: Removal of increased orbital fat.

POTENTIAL RISKS AND COMPLICATIONS

  • Major surgery with risks:
  • Rare infection and bleeding
  • CSF leak
  • Fine line scar hidden in outer corner eyelid lines.
  • Upper and lower eyelid swelling.
  • ‘Wobble’ vision on eating (oscillopsia).
  • Rare new onset double vision.
  • Extremely rare blindness.
  • Benefits of surgery generally outweigh risks; detailed discussion with surgeon
    advised.

PREPARATION FOR THE SURGERY

  • Avoid aspirin, aspirin-type medications, or anti-inflammatory medicines for three
    weeks before surgery.
  • Stop blood-thinning medications as advised by GP or cardiologist.
  • Surgery usually performed under general anaesthetic.

AFTER SURGERY CARE

  • Eye pads placed over operated eyes, removed the next day.
  • Mild pain relief medication recommended.
  • Additional recommendations:
  • Sleep on an extra pillow.
  • Take at least two weeks off work.
  • Avoid nose-blowing, flying, and scuba-diving for three weeks.
  • Avoid driving if experiencing new or worsening double vision.
  • Temporary drainage issues with medial wall decompression.

Further surgery after orbital decompression?

  • Possible during the second phase for severe cases or unmanageable symptoms.
  • Double vision after orbital decompression?
  • May improve but often persists. Eye muscle surgery may follow decompression
    surgery. Patching one eye or using a prism in glasses can help.