[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.146.184.210. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
May 1985

An Individualized Approach to Orbital Decompression in Graves' Orbitopathy

Author Affiliations

From the Departments of Ophthalmology (Dr Hurwitz) and Otolaryngology (Dr Birt), Sunnybrook Hospital, University of Toronto.

Arch Ophthalmol. 1985;103(5):660-665. doi:10.1001/archopht.1985.01050050052016
Abstract

• With better understanding of the various techniques available for orbital decompression, the indications for surgical decompression in Graves' orbitopathy are now less rigid. Decompressions may be performed for (1) prolonged orbital congestion and pain, (2) orbital problems resistant to steroid treatment, (3) orbital problems where there have been steroid complications, (4) severe corneal exposure that cannot be treated with lidlengthening surgery, and (5) the standard indication—Graves' optic neuropathy. Assessment of muscle size by computed tomographic scanning and ultrasound, as well as the measurement of orbital pressure, are important advances in the assessment of these patients. The lateral approach produces less strabismus and allows for exophthalmos reduction, especially if fascia temporalis is incised and if part of that muscle is removed. The inferomedial approach is advisable in patients with severe posterior optic neuropathy caused by apical crowding of the enlarged muscles, particularly the medial rectus. The two approaches may be combined in severe cases.

×