An orbital surgeon has trained in the understanding and treatment of any potential problem that can occur in the muscles, fat, nerve, bones and any other structure that exists around or behind the eye.
Thyroid orbitopathy is a complex condition affecting the fat and muscles around the eye. It may cause redness, pain, double vision, bulging eyes (proptosis), difficulty with eye closure or rarely damage to the nerve carrying vision to the brain. There are both non-surgical and surgical treatments available. Care of thyroid orbitopathy often requires the attention of an orbital specialist, and endocrinologist and an immunologist.
Bone and fat are removed from around the eye. This creates more space for the eye to move back into its normal position and takes pressure away from the nerve behind the eye. This procedure offers cosmetic rehabilitation, relief of chronic pain, reduces watering, may save vision if the nerve is compressed, or allow the eye to shut properly.
The eyelids may pull away from the eye in thyroid orbitopathy, and the eyes may appear to bulge even when they do not. In these cases the eyelid itself can have an operation through the natural skin crease to release the tight muscles and reposition the eyelid.
There is a large number of possible tumours that may grow behind the eye. Diagnosis depends on detailed history taking, examination and the results of CT or MRI scans.
The correct surgical approach to either biopsy or removal is tailored to the likely diagnosis and the location of the tumour, as important eye structures are avoided.
Unfortunately it is necessary to remove an eye in some cases of tumour or incurable pain in a sightless eye. Severely damaged eyes may be cosmetically unacceptable and removal may offer the best chance of improved appearances. The decision to remove an eye is taken carefully.
However, much can be done to ensure the reconstruction, and particularly the artificial eye, works well. The surgery aims to achieve a comfortable eye socket that will fit a cosmetic artificial eye to enable a person to look and feel normal.