Endocrine Exophthalmos Treated by Orbital Decompression

ORBITAL DECOMPRESSION P. R. R. CLARKE (Middlesbrough) discussed a series of 20 patients with endocrine exophthalmos treated by lateral orbital decompression. There had been 14 bilateral decompressions, and in six patients a unilateral operation only had been performed. One patient had needed reoperation. Four patients had no thyroid abnormality, and two had untreated hyperthyroidism. In 14 patients exophthalmos had progressed after treatment for hyperthyroidism. The treatment given for hyperthyroidism had been thyroidectomy in eight, radioactive iodine in one, radioactive iodine and thyroidectomy in one, thiouracil in three, and pituitary irradiation and thiouracil in one. Eighteen of the 20 patients had been relieved of orbital discomfort, photophobia, and pain on eyeball movement. Of 12 patients with diplopia, eight had lost this symptom after operation. Papilloedema had subsided after operation in two cases. A postoperative corneal ulcer had developed in one of the three patients who had preoperative keratitis. The one patient who had corneal ulcer before operation developed a recurrent ulcer after decompression. One patient with a blood dyscrasia developed a corneal opacity after surgery, and another patient required treatment for entropion. It was suggested that orbital decompression might be considered more frequently than is often the case in view of its success in relieving discomfort in a high proportion of cases.