Orbital decompression · Tumors · Fractures · Thyroid orbitopathy | Advanced specialization
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Orbital surgery covers the diagnosis and surgical treatment of conditions affecting the bony cavity that houses the eyeball, the eye muscles, and the periocular fat. It is indicated for thyroid orbitopathy (Graves’ disease) with exophthalmos, for benign orbital tumors —such as dermoid cysts or hemangiomas— and malignant tumors —such as lymphoma or rhabdomyosarcoma, or metastasis—, for fractures of the orbital floor and walls due to trauma, for orbital inflammatory processes, and for enophthalmos (a sunken eye) due to fat atrophy or a prior fracture.
In thyroid orbitopathy, when exophthalmos is severe or there is optic nerve compression or corneal exposure, orbital decompression is indicated: a surgery that creates space within the bony orbit for the inflamed tissue —fat and muscles— to expand, allowing the eye to return to a more normal position. Management of these cases is usually multidisciplinary, together with endocrinology to control the underlying thyroid disease.
When an orbital tumor is suspected, diagnosis combines clinical examination, imaging studies (CT scan or MRI), and, when necessary, an orbital biopsy with histopathological analysis. Warning symptoms include proptosis (the eye bulging forward), double vision, orbital pain, and progressive vision loss; depending on the type of tumor, treatment may require joint management with oncology.
Orbital fractures from trauma, if not treated promptly, can cause enophthalmos, permanent double vision from muscle entrapment, and facial deformity; surgical repair is usually most effective when performed within the first two weeks after the injury, so any facial trauma with changes in vision or eye position calls for an early eye exam.
Dr. Sebastián Diener is a certified specialist in Orbit, Eyelids, and Tear Ducts from the Conde de Valenciana Institute and the Mexican Association of Orbital and Oculoplastic Surgery (AMCOO). He has experience in orbital decompression for thyroid orbitopathy, in biopsies and histopathological analysis of orbital lesions, and in joint management with endocrinology, oncology, and maxillofacial surgery depending on each case; he also has publications and presentations at national oculoplastic conferences. This same subspecialty includes care of the eyelids and the tear duct, structures near the orbit that are frequently affected alongside it.
Do you have a bulging eye, did you have an orbital injury, or were you found to have a mass behind the eye? Book your appointment with Dr. Sebastián Diener and get a personalized evaluation.
What is orbital decompression and what is it for?
This surgery creates space within the bony orbit for inflamed tissue (fat and muscles) to expand, allowing the eye to return to its normal position. It is mainly indicated in patients with thyroid orbitopathy who have severe exophthalmos, optic nerve compression, or corneal exposure.
Is there a cure for bulging eyes caused by thyroid disease?
Thyroid orbitopathy is an autoimmune disease related to the thyroid. The exophthalmos (bulging eyes) it causes can improve significantly once the underlying thyroid disease is under control, and when it persists or is severe, orbital decompression creates space within the orbit for the inflamed tissue and allows the eye to return to a more normal position. It doesn’t always disappear completely, but most cases see significant improvement.
How is an orbital tumor diagnosed?
Diagnosis combines clinical examination, imaging studies (CT scan or MRI), and, when necessary, an orbital biopsy for histopathological analysis. Warning signs include proptosis (eye bulging forward), double vision, orbital pain, and progressive vision loss.
What happens if an orbital fracture is not treated?
Untreated fractures can cause enophthalmos (sunken eye), permanent double vision from muscle entrapment, and facial deformity. Surgical repair is most effective when performed within the first 2 weeks after the injury.
How much does orbital decompression surgery cost?
The cost depends on the type of orbital surgery needed, the technique used, and whether one or both eyes are affected; a written estimate is provided after your evaluation. If you have medical insurance, the procedure may be done through direct billing with major insurers or by reimbursement.
What are the symptoms of thyroid orbitopathy?
The most common symptoms are exophthalmos (bulging eyes), a feeling of dryness, irritation, or pressure in the eyes, redness, and eyelid retraction. In more advanced cases there may be double vision or decreased vision from optic nerve compression. If you have these symptoms, an eye exam is recommended to determine whether medical management, orbital decompression, or another treatment is needed.
