Endoscopic Orbital Decompression

Endoscopic orbital decompression is a minimally invasive, advanced procedure that was introduced in the early 1990s.

This procedure is typically performed for patients with Grave’s Disease, an inflammatory condition of the thyroid gland that can cause the eyes to bulge (exophthalmos) and may lead to loss of vision. When medical therapy fails – and vision starts being affected – then your specialist may recommend an orbital decompression to reduce the pressure in the orbit caused by the disease.

WHY IT’S DONE

The primary goal is to create more space in the orbit (bones around the eye) to allow the eye to return to a more normal position. This may also alleviate | reduce:

  • Eye dryness
  • Tearing
  • Abrasions of your eye

Endoscopic orbital decompression may also decrease the pressure inside your eye socket. This can prevent or improve double vision or loss of vision.  

WHEN IT’S DONE

Patients typically elect to undergo this procedure when the symptoms of exophthalmos become severe. This stage of the disease may include:

  • Chronic eye pain or headaches
  • Chronic eye irritation causing scar tissue over the cornea (keratitis)
  • Optic neuropathy and loss of vision

Endoscopic orbital decompression is also used to decrease the pressure within the eye socket (orbit) and stabilize or improve vision impacted by other eye-related issues:

  • Trauma to the head or eye
  • Infection of the eye (abscess)
  • Collection of blood (hematoma)
  • Tumor within or around the eye

HOW IT’S DONE

With the patient under general anesthesia, the procedure is accomplished with the use of an endoscope (small, rigid telescope) that allows the surgeon to go through the nose and sinuses to address root causes, and delicately decompress the eye socket.  It requires no cuts to the outside of the face — it is performed entirely through the nostrils.

If you have Grave’s disease, your surgeon will then make makes incisions allowing the excess fat of the eye to fill the sinuses, reducing the pressure in the orbit, and reducing the bulging of the eye. This procedure effectively enlarges the space of the orbit which, in turn, “decompresses” the entire eye.

THE EXPERT TEAM INVOLVED

Endoscopic orbital decompression surgery is typically performed by a coordinated multi-specialty team of surgeons trained in both sinus and orbital surgery: rhinologists, endocrinologists, and ophthalmologists.