Orbital Surgery & Decompression
Conditions inside the orbit, the bony socket that holds the eye, can push the eye forward, restrict its movement, or compress the optic nerve. Orbital surgery treats these conditions and restores both vision and appearance.
Thyroid eye disease (also called Graves’ eye disease) is the most common reason an adult develops bulging eyes. The tissues behind the eye, the orbital fat and the eye muscles, swell, and the eye is pushed forward in its socket. The result can range from a cosmetically apparent prominence to vision-threatening optic-nerve compression. Orbital decompression surgery removes precise amounts of bone and fat from the orbit to give those swollen tissues somewhere to expand, allowing the eye to settle back into a more normal position.
Decompression is technically demanding because it sits at the intersection of ophthalmology and reconstructive surgery. Done well, it restores eye position and protects the optic nerve while preserving binocular vision. Done aggressively or asymmetrically, it can introduce double vision that is then very difficult to correct. In addition to surgery, non surgical options include IV infusions with IGF-1R medications (ex: Tepezza)
Dr. Boxrud completed a fellowship in orbital surgery and ophthalmic oncology at New York Hospital, Cornell University Medical Center, before her oculoplastic fellowship at UCLA. That orbital training is the foundation of her practice. She treats thyroid eye disease, orbital tumors, and other orbital conditions in patients referred from across Los Angeles.
- Procedure
- Inpatient or outpatient depending on extent; typically performed under general anesthesia.
- Recovery
- Several weeks of visible swelling and bruising; final eye position settles over months.
- Coordination
- Care is often coordinated with an endocrinologist managing the underlying thyroid condition.
What is orbital surgery?
Orbital surgery refers to operations on the bony eye socket (the orbit) and its contents, including the tissues, muscles, fat, and structures surrounding the eye. It includes tumor removal, fracture repair, decompression for thyroid eye disease, and reconstructive work.
What conditions require orbital surgery?
Common indications include orbital fractures, thyroid eye disease (causing bulging eyes), orbital tumors (benign or malignant), congenital abnormalities, and severe trauma. Each is evaluated individually with imaging and exam.
Who should perform orbital surgery?
Orbital surgery is one of the most specialized areas of ophthalmic and facial surgery. It should be performed only by surgeons with formal fellowship training in oculofacial plastic and orbital surgery. Dr. Boxrud completed fellowship training in this exact subspecialty and has decades of focused experience.
Will my appearance change after orbital surgery?
For functional and reconstructive cases, the goal is to restore normal anatomy and appearance. For thyroid eye disease decompression, surgery can significantly improve the bulging-eye appearance. Each plan is discussed in detail before surgery.
How long is recovery from orbital surgery?
Recovery depends on the specific procedure. Most patients return to non-strenuous activity within one to two weeks; full settling of swelling and final result can take several months.
Is orbital surgery covered by insurance?
Typically yes. Orbital surgery is functional and medically necessary in most cases and is covered by insurance with appropriate documentation, though coverage details vary by plan.