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Proptosis

Bulging eye of a person with proptosis

Proptosis, also known as exophthalmus, is the bulging of the eyes; one or both eyes are affected. When the eyes bulge they become trapped behind the eyelids. If preventative measures aren’t taken the cornea becomes dry and may become damage. In severe cases, patients may start to go blind. Once proptosis is seen, it should be reported, as it’s considered serious. A doctor will do an examination, and determine what action to take. If proptosis surgery is needed, one of the following two surgeries will take place, either a bilateral or unilateral orbital decompression surgery. The difference being, bilateral is surgery on both eyes, and unilateral is surgery on one eye. The most common cause of bilateral proptosis is Grave’s Disease, while the most common cause of unilateral proptosis is a tumor. 

The surgery involves removing fat and bone to allow the eyeball to sit back into the socket. The surgery will either be done by an incision to the skin next to the eye, or can be done going through the nose. As with any surgery, there are risks involved. The risks include retinal or optic nerve damage, infection, and scarring of the incision. The risks involved are rare, and most doctor’s report that they have never had a major complication while performing an orbital decompression. The biggest risk involved is the procedure failing, or needing to have another procedure so the eyes can sit further back into the sockets.

The majority of the time the benefits outweigh the risks, as surgery is the last resort option for proptosis. Benefits include the eyes sitting inside the sockets, subsiding proptosis. Other benefits include easing discomfort, and lowering intraocular pressure. For patients that were about to lose their sight, will have the benefit of vision. Blurry vision and dryness of the eye normally subsides after surgery, and with success of a surgery, worries of cornea damage and loss of sight will diminish.

Depending on what type of procedure is used during the surgery, it will determine how long your hospital stay is. As long as no complications arise, surgery that does not require a skin incision (through the nose, transnasal), is an out-patient procedure. This means that the patient goes home the same day as the surgery. If a skin incision is used, the patient will be monitored overnight, and then allowed to return home the following day. The total healing process occurs within a few months, with some variances depending upon the patients’ medical history.

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