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How Orbital Decompression Surgery Helps

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How Orbital Decompression Surgery Helps
August 22
07:39 2016

Article Highlights

  • In a person afflicted with thyroid eye disease, harmful antibodies attack normal tissues in the body, specifically around the eyeball or orbit
  • Symptoms can include anything from mild eye pain, eye irritation, dry eyes and fullness around the eyeball, and even vision loss
  • Proptosis, or swelling and inflammation behind the eyeball causing the eyeball to protrude forward

Thyroid Disease Sufferers Have Healthy Eyes Again

The eyes can tell you so much about a person. When looking into someone’s eyes, you can gauge whether they are happy or insecure, humble or audacious, honest or deceptive. Indeed, the eyes can speak louder than words. With thyroid eye disease, however, the window to the soul becomes foggy and distorted, and that essential language is lost.

Dr. Yasser Khan, an eye physician and surgeon at Carrot Eye Surgery Clinic in Mississauga, said that the problems associated with thyroid eye disease are numerous. In a person afflicted with thyroid eye disease, harmful antibodies attack normal tissues in the body, specifically around the eyeball or orbit (the part of the skull that houses the eyeball itself), which contains muscles, fat, nerves, connective tissue and blood vessels.

Symptoms can include anything from mild eye pain, eye irritation, dry eyes and fullness around the eyeball, and even vision loss, to actual visible signs of thyroid eye disease, such as eyelid retraction, which is scarring in the eyelid tissue, where the upper eyelids retract upwards and the lower eyelids go downwards. This is what gives a person that wide-eyed look, which is symptomatic of this autoimmune disorder, stated Dr.Khan.

Another thing that can happen with thyroid eye disease is proptosis, or swelling and inflammation behind the eyeball causing the eyeball to protrude forward. Sometimes, the eyeball muscles that move the eyes swell up to four, five or even six times the normal size, explained Dr. Khan. The orbit in which the eyeball resides can only hold so much, so when the inflammation or swelling is severe, the eye gets pushed out (proptosis), and that’s when you get those very prominent, bulging eyeballs, he added.

“Overall, you can well imagine, it’s a huge, dramatic change in appearance,” Dr. Khan noted. “Patients transform from looking normal to really having this sort of wide-eyed, swollen appearance. It affects them socially and professionally such as getting a job, going to work, and being confident.”

However, there are solutions. Orbital decompression is one of them. The surgery can help move the eyes of thyroid sufferers back to a more “normal” position and cosmetically improve their appearance, clarified Dr. Khan, who performs this type of procedure on a regular basis. The procedure typically takes between one to three hours (depending on whether the procedure is required for one or both eyes), during which you are put under general anesthetics and are asleep. The doctor then makes an incision on the inside of the eyeball (the conjunctiva) or on the outside of the skin, dissecting all the tissues away from the bone and then breaking down or fracturing a few of the walls of the orbit,

“By breaking the walls of the orbital skull down you basically are making a hole in part of the orbit, where the muscle and fat can expand into,” explained Dr. Khan. “The bones are actually very soft, so it’s not very hard to fracture them and to make a hole, so that the tissues can expand into these spaces and the cavities that are created.” Overall, this creates more space in the orbit for the eyeball and larger tissues.

To decrease swelling after the procedure, you would need to put cold compresses on your eyes, as well as take painkillers, and anti-nausea medication if needed. Your surgeon would also prescribe topical ointments in order to prevent infection and to keep your eyes lubricated.

According to Dr. Khan, the patient’s appearance as well as their eyesight improves significantly after the procedure, and those results can be permanent.

“If they [patients] do it for cosmetic reasons, their eyes will move back, so that they have less of a bulging eye appearance,” Dr. Khan said. “The eye is much more comfortable. Their dry eye decreases, because now their eyelids cover their eyeballs. They often experience less fullness and feel better. They also look better, so that also aids to their whole general wellness.”

As with any surgery, there are potential risks. With the orbital decompression procedure, misalignment of the eyeball and double vision can occur, as the eyeball expands into new spaces. In extremely rare cases, the optic nerve can be affected, which can result in vision loss.

That being said, the operation is quite safe when performed by a well-trained and qualified specialist. And getting the procedure done does more than just helping you look and feel better—it can also help save your eyesight, said Dr. Khan.

“If you have compression of the optic nerve and don’t do something about it, it can permanently affect your vision, and you will eventually lose your vision. Once the optic nerve is damaged by that outside compression, the damage can be irreversible,” concluded Dr. Khan.

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