Abstract
Introduction High myopic eyes grow in length (> 0.35 mm/dpt) more than in height and width leading
to a disturbing unilateral exophthalmos in patients with anisomyopia and – more rarely
– a bilateral exophthalmos in high myopia affecting both eyes. Secondary consequences
are sicca symptoms and painful eye mobility due to a large bulbus in a too small bony
orbit. The aim of the work was to evaluate the effectiveness of bony orbital compression
in cases of high myopia.
Material and Methods Four patients underwent bony orbital decompression between the years 2012 and 2019.
Two of the patients received lateral and two of them balanced (medial endonasal endoscopic
and lateral) decompression. The decompression effect, complications and the influence
of decompression on eye position and motility were evaluated.
Results Significant decompression effect was achieved in all patients. As a result, symmetry
was restored in all unilaterally affected patients. No complications occurred. The
lateral decompression had a positive effect on the preexisting convergent strabismus
(reduction of the “eso” position, neutral to the vertical deviation). The carefully
dosed medial decompression did not lead to any change of the horizontal position in
one patient and in the other exotropic patient it resulted in a 10 pdpt of “exo” reduction
without developing an “eso” position.
Discussion The bony orbital decompression provides a sufficient decompression effect in the
four patients to reduce the myopic pseudoexophthalmos. The alignment anomalies associated
with a high myopia (“heavy eye”) was favourably influenced by the lateral decompression.
Key words
orbital decompression - orbit - exophthalmos - high myopia
