Restrictive Vertical Strabismus Following Orbital Decompression
Orbital decompression is warranted when patients with endocrine myopathy experience optic nerve compromise, corneal exposure problems or significant limitation of ocular motility as a consequence of extreme proptosis. The procedure may create a strabismus in a previously orthotropic patient or exacerbate existing oculomotor dysfunction. Strabismus may result from entrapment of orbital contents, including extraocular muscles, in the decompression site. Neuroimaging may be of considerable assistance if this complication is suspected, and orbital exploration to release adhesions by a qualified oculoplastic surgeon should be performed prior to strabismus repair.