Orbital decompression. Any suggestions?

I have inherited bulgy eyes and want an orbital decompression surgery. I do not have Graves. The low risk of blindness worries me. Would just removing fat rather than shaving down one of the bones reduce the risk of blindness? Is it due to the optic nerve or the central retinal nerves? How many people have experienced permanent blindness after decompression? Thanks

Doctor Answers 5

Orbital decompression for non-Graves

Find an Oculoplastics surgeon who has done a lot of decompression and ask to look at his/her pre/post photos. In my opinion and experience, when orbital decompression is done for cosmetic purposes, the outcome can be very subtle and may not be able to accomplish what you are hoping for. 

Pasadena Plastic Surgeon
5.0 out of 5 stars 28 reviews

Orbital decompression for prominent eyes

Orbital surgery does carry more risk than eyelid surgery. Fat removal will do very little for the position of the eyeball in the socket. Look into this with more than one consultation - you do need to connect with an oculoplastic & orbital surgeon. If you have maxillary hypoplasia, or other anatomical bony issues, orbital decompression might not be the way to go. Decompression for cosmetic purposes is most successful and gratifying in patients who have good-sized sinus spaces - maxillary and ethmoid - so that the orbital soft tissues may expand into air-filled spaces. Blindness is rare - I am thankful that I have not seen this complication in my patients over 30+ years of practice. Take your time with this decision. Get what you want out of your surgery. Best wishes!

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Orbital decompression for non-Graves bulging eyes

Orbital decompression can be done for nonGraves patients for cosmetic reasons. In fact, the risks are much lower for nongraves patients as the eye socket is healthy. Best to see an experienced oculoplastic surgeon with cosmetic orbital decompression surgery. See link below for more details.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

I have studied your photos.

In my opinion based on these photos, you should not have orbital decompression.  Not only would it put you at unnecessary risk but it will harm your appearance in potentially unfixable ways.  

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Orbital decompression and risk of blindness

Any surgery that occurs near the eye risks damage to the eye with resulting loss of vision. This includes orbital decompression, blepharoplasty (eyelid surgery), and even sinus surgery. 
Problems that may occur related to surgery are direct injury to the eye and nerve itself or bleeding around the eye that puts pressure on the eye.
The amount of risk in orbital decompression surgery is extremely low with good technique and assistance by technology like image-guidance systems. Orbital decompression is actually the procedure performed when blood is putting pressure on the eye. 
I recommend speaking with your surgeon regarding your specific anatomy and risk profile. Safety comes first.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.