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Orbital Decompression Specialist

Dr Raymond Douglas - Best Oculoplastic Surgeon In California

Raymond Douglas, MD, PhD

Oculoplastic Surgeon located in Beverly Hills, CA & Long Beach, CA

Approximately 20 million Americans suffer from some form of thyroid disease. If you’re one of the millions of Americans suffering from eye complications due to thyroid disease, Raymond Douglas, MD, PhD, can help with an orbital decompression at his office in Beverly Hills, California. Whether you have severe eye irritation or exophthalmos — a condition that causes bulging eyes — Dr. Douglas delivers world-class care in the field of oculoplastic and reconstructive surgery, with a specialty in patients with thyroid eye disease. Call the office or schedule an appointment with Dr. Raymond Douglas, MD, PhD, online today to learn more.

Orbital Decompression Q&A

What is orbital decompression?

Orbital decompression is a surgery that removes bone and fat from the socket, or orbit, of the eye to relieve the symptoms of eye conditions, like exophthalmos — a condition that causes your eyes to look like they’re coming out of their sockets (bulging eyes).

This happens because thyroid eye disease causes inflammation in the eye muscles and fatty tissue behind the eye.

What are the symptoms of thyroid eye disease?

While bulging eyes can have many causes, you may have exophthalmos if you’re diagnosed with a thyroid condition, particularly Graves’ disease — an immune system disorder of the thyroid. 

Some of the most common symptoms of thyroid eye disease include:

  • Inability to close your eyes completely
  • Bulging eyes
  • Double vision
  • Dry eye
  • Eye irritation
  • Feelings of grittiness in the eyes
  • Inflammation of the eyeball
  • Increased orbital pressure
  • Eyeball deformation

In rare cases, untreated thyroid eye disease can impact your vision and lead to vision loss.

What happens during an orbital decompression?

The team has a completely customized approach to orbital decompressions, intending to restore your appearance and eye function. Before your surgery, they order a CT scan to see precisely which areas of the eye should be targeted during the procedure. They also perform a full eye exam and take measurements of your eye protrusion.

To ensure your comfort, the team performs orbital decompression with general anesthesia, so you aren’t awake during the procedure. First, they make a small incision in the upper eyelid crease or through your caruncle — the inner corner of your eye — before removing a portion of the bone between the eye and the nose. They also take out the part of the bone that creates the outer wall of your eye socket. If necessary, they may remove bone from under your eye.

Next, the team makes another incision in the thin lining that covers your eyeball, allowing the fat and muscle around the eye to expand. For aesthetic purposes, they may remove a small amount of fat surrounding the eye.

What can I expect from my orbital decompression recovery?

To reduce swelling and minimize your risk of infection, the team may prescribe antibiotics, pain medication, or corticosteroids. You shouldn’t lift anything heavy, bend over, or blow your nose for at least the first week after the procedure.

It’s important to avoid strenuous activity for about two weeks during your recovery. Minor pain and swelling are normal side effects of orbital decompression surgery. However, call the team right away if you experience severe swelling, bleeding, or pain.

Dr. Douglas is highly experienced in customized orbital decompression. To learn more, call Dr. Raymond Douglas, MD, PhD, or book a visit online today.

Figure 1:
A 32-year-old woman with history of thyroid eye disease and displeased with eye bulging, increased periorbital fat expansion and buccal fat expansion. She underwent a bilateral upper eyelid blepharoplasty, bilateral lateral wall decompression, bilateral lower eyelid blepharoplasty with fat repositioning, and bilateral buccal fat removal. Panel A shows preoperative photo and B shows postoperative photograph at 4 months.
Figure 2:
Pre-(A) and 6 weeks post-surgical (B) photographs of a 30-year-old woman who suffered from thyroid eye disease. She underwent bilateral lateral wall, medial wall, and fat decompression, bilateral lower eyelid retractor release, bilateral fat grafting to the cheeks and nasal mid face, bilateral buccal fat removal and bilateral Kybella injection to face.
Figure 3:
Pre-(A) and 4 weeks post-surgical (B) photographs of a 30-year-old man who suffered from thyroid eye disease. He underwent bilateral lateral wall, medial wall, and fat decompression, left upper eyelid posterior approach blepharotomy, bilateral fat grafting to cheeks, nasal mid face, and temples, bilateral buccal fat removal and bilateral Kybella injection to face.
Figure 4:
Pre-(A) and 2 months post-surgical (B) photographs of a 26-year-old woman who suffered from thyroid eye disease with right sided proptosis much worse than left. She underwent bilateral lateral wall and fat decompression, right medial wall decompression, right upper eyelid posterior approach blepharotomy, and bilateral fat grafting to cheeks and nasal mid face.