Cosmetic Orbital Decompression (For Bulgy Eyes)
Understanding Why Eyes Bulge
The most common cause of bulging eyes is thyroid eye disease, also known as Graves' eye disease. This condition occurs when your immune system causes the muscles and fat behind your eye to swell. Because the eye socket is a bony box with limited space, this swelling pushes the eyeball forward.
Orbital decompression creates more room behind your eye so it can settle back into a normal position. During the procedure, our ophthalmologists remove small sections of bone and sometimes fat from the eye socket. This extra space relieves pressure on the eye and the optic nerve.
- The eye moves back to a more natural position
- Eyelids can close more easily, reducing dryness
- Pressure behind the eye is relieved
- Overall facial appearance is restored
Surgery is not always the first step. If your thyroid eye disease is in the 'active' phase, meaning inflammation is still changing, we may recommend medical treatments first. New medications and therapies can help reduce bulging and double vision without surgery. Our team will review your specific case to see if medication, steroid treatments, or other supportive care is the right place to start.
Evaluating Your Eyes for Surgery
Before we schedule surgery, we perform a comprehensive evaluation at our Marlton clinic. We use advanced technology to measure exactly how far your eyes bulge and check your vision thoroughly. We also test for dry eye and assess how well your eyelids close.
We use CT scans to see the bony structure of your eye socket in great detail. This helps our ophthalmologists plan exactly which pieces of bone to remove to get the best result safely. We may also use MRI scans to look at the muscles behind the eye.
- CT scans show us the bone structure clearly
- Imaging helps us protect the sinuses and nerves
- We create a personalized surgical map for your anatomy
Thyroid eye disease often stiffens the eye muscles, which can cause double vision. We carefully test your eye movements before surgery. Knowing your current vision status helps us predict how surgery might change the way your eyes work together.
In most cases, we wait until your thyroid eye disease is stable for at least six months before performing cosmetic decompression. Operating while the disease is still active can lead to unpredictable results. We will coordinate with your endocrinologist to ensure your thyroid levels are under control.
The Decompression Procedure
Orbital decompression is performed under general anesthesia, so you will be asleep and comfortable. Our ophthalmologists use minimally invasive techniques to access the eye socket, often making small incisions hidden in the eyelid crease or working through the nose.
Your surgeon carefully removes thin sections of bone from the walls of the eye socket. If needed, we also remove excess fat from behind the eye. This allows the swollen tissues to relax into the new space. The surgery typically takes between one and three hours, depending on whether we are treating one or both eyes.
Most patients go home the same day, though you will need a friend or family member to drive you. In some complex cases, we may recommend an overnight stay for observation. We provide detailed instructions on how to care for your eyes before you leave our surgical center.
Recovery and Healing
Recovery is a gradual process. You will likely have bruising and swelling around your eyes that peaks after two or three days. We recommend sleeping with your head elevated on pillows and using ice packs gently to help reduce swelling.
To ensure proper healing, you must avoid heavy lifting, bending over, and nose blowing for at least two weeks. These actions can increase pressure in the head and affect the healing eye socket. Most people can return to desk jobs within two weeks, but more active jobs may require more time off.
- Do not blow your nose for two weeks
- Avoid strenuous exercise and swimming
- Walk lightly to improve blood flow
- Take prescribed antibiotics or eye drops as directed
It is normal to feel some numbness in the cheek or upper teeth area right after surgery, which usually fades over time. You might also have some double vision as your eye muscles adjust to their new position. This often improves as swelling goes down.
Frequently Asked Questions
It depends on the reason for the surgery. If the bulging causes medical problems like vision loss, severe dry eye, or damage to the cornea, insurance often considers it medically necessary. If the surgery is done only to improve appearance, it is considered cosmetic and is usually not covered. We will help you understand your benefits.
Double vision is a known risk of orbital decompression. Because the eye position changes, the muscles act differently. For many patients, this is temporary and resolves as you heal. In some cases, special glasses or a corrective muscle surgery may be needed later.
Yes. Smoking significantly worsens thyroid eye disease and makes treatments less effective. It also slows down healing after surgery and increases the risk of complications. We strongly advise stopping all nicotine products well before your procedure.
Yes, we often operate on both eyes during the same surgery if both need correction. This means you only have to go through one recovery period. However, the decision depends on your specific anatomy and health, which we will discuss during your consultation.
The amount of correction depends on how many walls of the bone we remove. On average, the eye can move back anywhere from 2 to 6 millimeters. Our ophthalmologists tailor the surgery to achieve a natural look that balances with your facial features.
Expert Care in Marlton and South Jersey
Living with bulging eyes can be difficult, but you do not have to face it alone. The team at ReFocus Eye Health Marlton combines advanced surgical skill with a compassionate approach to patient care. Whether you are coming from right here in Marlton, nearby Evesham, or crossing the bridge from Philadelphia, we are dedicated to helping you look and feel your best.
Dr. Grossman is brilliant and compassionate, I’ve been a patient for more than 30 years, and have sent him numerous family members who are also enamored of him. His staff are outstanding as well.
Claire Zelman
Dr. Grossman is one of the most sympathetic, thorough doctors I have ever been to. He and his staff clearly are confident, and interested in your overall health. Thank you for all you do.
Rosemary Reichard
Highly recommend Dr Charles Glass. Did a great job on my cataract surgery. He listens to patients and helps you figure out what works best for you! Could not be happier with him and The Refocus Marlton Team!
Jacquelyn DePiano
Dr Johnson and staff very friendly and helpful I look forward to my next visit
Jeri Priolo
The staff is friendly and pleasant. The wait time was very reasonable. Dr. Grossman is very personable and thorough. He explained things clearly and concisely.
Jack Shaw
Contact Us
Tuesday: 8am-7pm
Wednesday: 8am-7pm
Thursday: 8am-7pm
Friday: 8am-5pm
Saturday: 9am-2pm
Sunday: Closed