Orbital decompression - are situations like ptosis and scleral show corrected with it?

I know orbital decompression surgery deals with setting the eyeballs back but are situations like ptosis and scleral show corrected with it or will i have to pay an additonal amount for eyelid surgery? Thanks

Doctor Answers 5

Eyelid position change after orbital decompression ?

Ptosis is not corrected by orbital decompression but eyelid retraction may improve with orbital decompression. Lower eyelid retraction can sometimes be addressed at the same time as decompression but not upper. It really depends on your anatomy among other factors. See following link.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Decompression surgery

Decompression surgery makes the space around they ey bigger and allows the eye to move back. Through a customized process this can predictably improve the lower eyelid scleral show. Most studies show that the upper eyelid does not move or if it does it may become lower or more ptotic. 

Decompression surgery is a procedure that should only be undertaken for appropriate patients and by someone with tremendous experience. This surgery is complex and can have complications so advice from an orbital surgeon is critical 

Raymond S. Douglas, MD, PhD
Beverly Hills Oculoplastic Surgeon

Please be aware that orbital decompression is being touted as a cosmetic treatment.

It is not a cosmetic treatment.  It is a reconstructive surgery that has a long list of potential complications including a significant risk of visual loss from uncontrolled bleeding behind the eye.  It is performed when the benefits out weigh the risks.  Orbital decompression will generally make ptosis worse.  It can improve lower eyelid scleral show.  However in many cases these changes are not predictable and may require unanticipated surgical correction.  Consider posting your photos here to get Realself input on the appropriateness of having an orbital decompression.

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

Orbital Decompression

Hi laurence56, 

Thanks for your question. You are correct that orbital decompression surgery is performed to set the eyes further back in the orbit (eye socket). Typically, ptosis is not improved by this surgery but scleral show (superior and inferior) can be improved from this procedure. If it is being performed for Grave's disease (thyroid eye disease) or other non-cosmetic issues, the insurance company will often approve a second procedure to treat ptosis and/or scleral show. 

I hope this helps!


John McCann, MD, PhD
Sandy Oculoplastic Surgeon
4.8 out of 5 stars 4 reviews

Eyelid Surgery

Scleral show will most likely be corrected with decompression as it will allow the eyeball to sit further back and the eyelid to cover more of the eyeball. However, it most likely will not help to correct ptosis, as ptosis is a problem with the muscle that holds up the eyelid.

That being said, It is hard to definitively diagnose a problem from a picture and I would recommend seeing an oculo-plastic surgeon which is an ophthalmologist with a concentration in plastic surgery specifically around the eyelids.

Dan Landmann, MD
Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 43 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.