Decrease in intraocular pressure after orbital decompression for thyroid orbitopathy

Sundeep Dev, Karim F. Damji, Christopher M. DeBacker, Terry A. Cox, Jonathan J. Dutton, R. Rand Allingham

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Background: The effect of thyroid orbitopathy on intraocular pressure (IOP) remains controversial. We carried out a study to determine the effect of orbital decompression surgery on the IOP in patients with advanced thyroid orbitopathy. Methods: The records of 12 consecutive patients (22 eyes) who underwent decompression surgery for severe thyroid orbitopathy between 1985 and 1996 were reviewed. All patients were maintained on essentially the same medications before and after surgery. The IOP readings, obtained by means of applanation tonometry in primary gaze, from the pre- and postoperative visits were recorded, and the net change was calculated. Results: The mean preoperative and postoperative IOP values were 19.8 mm Hg and 16.8 mm Hg respectively, a significant difference (p = 0.008). Seven of eight eyes with an IOP of 21 mm Hg or greater preoperatively had a postoperative IOP less than 21 mm Hg; these eyes showed a mean decrease in IOP of 5.6 mm Hg. The degree of preoperative IOP elevation was found to be a strong predictor of the amount of IOP lowering after surgery (p = 0.014). Interpretation: Our results support the concept that orbital congestion associated with thyroid orbitopathy produces an increase in IOP by elevation of episcleral venous pressure (EVP) and that orbital decompression may reduce the IOP by decreasing EVP. Decompression surgery may obviate the need for more aggressive management of glaucoma in patients with severe thyroid orbitopathy.

Original languageEnglish
Pages (from-to)314-319
Number of pages6
JournalCanadian Journal of Ophthalmology
Issue number6
Publication statusPublished - Oct 1998
Externally publishedYes


  • Episcleral venous pressure
  • Intraocular pressure
  • Orbital decompression
  • Thyroid eye disease


Dive into the research topics of 'Decrease in intraocular pressure after orbital decompression for thyroid orbitopathy'. Together they form a unique fingerprint.

Cite this