Do you have ‘large eyes’ that are often red and burning? You could have thyroid eye disease, high myopia (those having excessive “minus” power glasses), or it could simply be hereditary. In addition to being vulnerable to increased exposure to air and dust, prominent eyes are a cosmetic blemish. Particularly troubled are the ones who have thyroid eye disorder, who continue to have the look even after the thyroid levels are controlled. With the refractive surgery trend to eliminate glasses on the rise, myopes with ‘prominent’ eyes now stand exposed as they can no longer remain hidden behind their glasses!

The latest in ophthalmic plastic surgery now makes it possible to correct this appearance with minimally invasive decompression techniques. This 1-3 hour surgery corrects the bulging appearance of the eyes, reduces fat bags around it. Patient requires a day’s admission, and usual recovery time from bruises and swelling is 1-2 weeks, and patients are usually ambulatory after surgery. Since this surgery involves structures close to the nerves of the eye, theoretical risks of temporary double vision does exist. The most serious complication is vision loss, but it is practically eliminated with the new and improvised approaches, and remains theoretical.   

Decompression surgery is a highly specialized keyhole surgery that involves removal of excessive fat from behind the eye, or widening the bony orbit of the eye with the help of fine drills. This allows for the prominent eyes to relax back into the socket, giving a more natural look. The procedure can be somewhat likened to an ice-cream. The bony eye socket is like the ice-cream cone, and the eye is the ice-cream. We need to widen the cone for the scoop to settle back in position!

Earlier, this kind of surgery was performed through large incisions in the scalp, leaving ugly scars. The current keyhole surgical techniques achieve the same through small, sub-centimetre hidden incisions. Decompression surgery is performed through an incision hidden within the upper eyelid fold, or from inside the eyelid (trans-conjunctival) so that there are no visible scars. 

Geetha Iyer’s is a typical case where orbital decompression surgery has restored what thyroid eye disease had done over 15 years. Six months after surgery, she is now able to wear contact lenses, and can even use eye makeup. The surgery, in this case, can clearly be termed as ‘rehabilitative’ as the attempt was to restore the patient’s appearance to that which existed prior to the onset of the thyroid disease process.

However, nowadays, with the evolution of finer and less invasive surgical techniques, more and more patients are opting for decompressive surgery to cosmetically improve their appearance.

This post was compiled with expert inputs from Dr Milind Naik, Consultant - Ophthalmic and Aesthetic Facial Plastic Surgery at L V Prasad Eye Institute, Hyderabad.

*Image courtesy: © Thinkstock photos/ Getty Images