Orbital Surgery / Thyroid Eye Disease
The orbit is made up of the bones that surround the eye and all of the contents within the eye socket. This area can be affected by inflammation (including thyroid disease), trauma, infection, or tumors that develop within the orbit or have spread from elsewhere in the body. These disorders can cause the eyeball to be moved, oftentimes either to bulge out or sink in. There may also be noticeable swelling in the area surrounding the eye or double vision. These orbital diseases can be benign or malignant and it is important to be evaluated since they may impact your sight or be life-threatening.
Depending on the possible diagnoses, an orbital biopsy, excision, or repair may need to be performed. Usually orbital surgery can be performed through hidden incisions inside the eyelid or in a crease surrounding the eye. Other types of orbital diseases can be treated medically or with radiation, chemotherapy, or immunotherapy.
During the initial office visit, Dr. Liu will perform a comprehensive orbital and eye exam. If you have had any prior imaging performed of the face, we ask that you please bring a copy with you on a CD to be reviewed by Dr. Liu. If prior imaging has not been performed, Dr. Liu may order specialized imaging of your orbits to better assess the area. Relevant labs may also be ordered to help establish the diagnosis.
Most types of orbital surgery are performed under general anesthesia at an outpatient surgery center where you can go home the same day.
When dealing with any problem near the eye, you need to see a physician trained as an ophthalmologist. Many doctors are not comfortable working in that area because of the specialized anatomy and will refer you to an ophthalmologist anyway. Additionally, because this is an extraocular procedure (outside of the eye) as opposed to an intraocular procedure (inside of the eye), the best choice for ectropion surgery is an oculoplastic surgeon (also known as an ophthalmic plastic and reconstructive surgeon).
A well-trained oculoplastic surgeon can combine their knowledge of the eye with the artistic expertise of a plastic surgeon. You need a doctor that can ensure that the procedure is done correctly, but also won’t leave an unsightly scar near your eyes. Dr. Liu is an oculoplastic surgeon and has completed an ASOPRS fellowship, making her one of the most highly qualified oculoplastic surgeons in North America.
The approach to orbital surgery depends on the location and size of the orbital disorder. The majority of orbital surgery can be performed through hidden incisions inside the eyelid or in a crease surrounding the eye to minimize any scarring. Large orbital disorders may require a multi-specialty approach in collaboration with neurosurgery, otolaryngology, or maxillofacial surgery.
Orbital surgery usually takes about 1-2 hours from start to finish.
Since Dr. Liu prefers to perform orbital surgeries minimally-invasively and through small, well-hidden incisions, the risk of scarring is minimized.
Orbital surgery is generally a safe procedure. When considering any orbital surgery, it is important to inform your surgeon of any abnormalities of your eyes, vision, or your general medical health.
It is important to remember that all surgery carries some risks, even when performed by the most highly trained surgeon and at the best facilities. Below are some of the risks associated with orbital surgery:
The likelihood of serious complications arising from the procedure is typically influenced by both the surgeon’s skill as well as the patient’s individual response to orbital surgery. Certain severe risks or complications can be avoided by cooperating fully and completely following your surgeon’s instructions. With patience, a willingness to cooperate, and a qualified surgeon, the complications of orbital surgery and any associated risks can be reduced.
Surgery should be scheduled for a time when you can relax for at least 2 weeks. It is important to avoid any strenuous activity, heavy lifting, or bending down during this time to avoid complications and to promote the best healing. It is also important to avoid taking any blood thinning medications around the time of surgery. If you are on a blood thinning medication due to a specific medical condition, you will need to discuss this with Dr. Liu and your primary care physician prior to stopping any medication. Dr. Liu’s staff will review a list of common medications, supplements and vitamins that can cause your blood to be thinner.
Please note that Dr. Liu expects to see patients back in the office a few days after a procedure to ensure that the healing process is going as expected and that you are on track for a good result. Do not plan any travel immediately after your procedure.