From the Guidelines
Reducing an eyeball, specifically in the context of proptosis or exophthalmos, can be achieved through large extraocular muscle resections, which can reposition the globe within the orbit, thereby reducing protrusion. This approach is supported by the adult strabismus preferred practice pattern 1, which highlights the importance of surgical techniques in managing sensory strabismus and associated eyelid or globe position abnormalities.
Key Considerations
- The use of large extraocular muscle resections can improve globe position and reduce proptosis or exophthalmos 1.
- Surgical treatment should be considered under the guidance of an experienced ophthalmologist, given the potential risks, including scleral perforation, new onset diplopia, and disruption of extraocular muscles 1.
- Diagnosis and management of sensory strabismus, which may include proptosis or exophthalmos, require comprehensive training and clinical judgment 1.
Treatment Approach
- Large extraocular muscle resections can offer a dual benefit by improving concomitant ptosis or enophthalmos and reducing proptosis or exophthalmos 1.
- The decision to proceed with surgical intervention should be made after discussing the findings, explaining the disorder, and outlining management options with the patient and any caregivers 1.
From the Research
Reducing an Eyeball
To reduce an eyeball, various surgical techniques can be employed, depending on the underlying condition and the patient's requirements.
- Enucleation and evisceration are two main procedures for removing the eyeball, each with its own advantages, disadvantages, indications, and contraindications 2.
- In cases of Graves' disease, endoscopic orbital decompression can be an effective treatment for proptosis and visual loss, with a mean orbital regression of 3.70 mm noted in one study 3.
- The surgical technique for endoscopic orbital decompression involves the removal of the medial and part of the inferior wall of the orbit and slitting of the orbital periosteum 3.
- Reduction in proptosis can vary within the first year after surgery, with the smallest proptosis measurements often documented between 6 and 12 months 4.
- Systemic steroids can be used to treat acute painful proptosis in patients with Graves' disease, with rapid resolution of physical signs and reduction in the size of extraocular muscles on CT scanning 5.
- In cases of ocular trauma, a detailed history and complete ocular examination are crucial, and timely treatment or referral can prevent blindness 6.