Orbital Surgery in Antalya: Tumor Surgery and Orbital Decompression

The orbit is the bony socket that holds the eye, the muscles that move it, the optic nerve, fat, blood vessels and the tear gland. Surgery there is needed for two quite different reasons: a growth that must be diagnosed or removed, and thyroid eye disease, in which swollen tissue pushes the eye forward.

This page explains both operations, what they can achieve, their risks and the recovery. It also covers the order of treatment when several operations are needed.

What is orbital surgery?

Orbital surgery means any operation inside the eye socket, around or behind the eyeball. The eye itself is not opened. The surgeon reaches the orbit through a natural skin crease, the inside of an eyelid or the inner corner of the eye. Some deep areas are reached through the nose, together with ear, nose and throat (ENT) surgeons.

The two main operations are:

• Orbitotomy: opening the orbit to take a sample of a growth (a biopsy) or to remove it.
• Orbital decompression: removing some of the orbital fat, part of the thin bony walls, or both, so that swollen tissue has more room.

Fractures of the orbit are also treated with orbital surgery. After injuries, this is planned together with orbital and maxillofacial surgeons; see war-related eye injuries.

When is a tumor behind the eye operated on?

A growth in the orbit is first studied with MRI and CT. Some are watched, some need a biopsy and some are removed whole. The types of orbital tumors, the scans and the signs that need urgent attention are described on the page about orbital tumors.

An orbitotomy is the operation that opens the orbit. The route follows the position of the growth. Most routes go through a crease of the upper lid, the inside of the lower lid or the inner corner of the eye, so any scar is small or hidden. The tear gland and the deep outer orbit are reached through a lateral orbitotomy: a piece of the outer bony rim is lifted out and put back at the end. Deep growths near the back of the orbit may be reached through the nose with ENT surgeons, or through the skull with neurosurgeons.

Whether the growth is sampled or removed depends on its type. A well-defined benign lesion, such as a cavernous venous malformation, is usually lifted out in one piece. A growth that spreads into the tissue, such as lymphoma, is sampled, and treatment continues with radiotherapy or medicines. The results vary: in a British series of 166 orbital biopsies, the most common findings were inflammation (38%) and lymphoma or related conditions (25%).

What are the risks of orbital tumor surgery?

After a lateral orbitotomy, the eye may not move fully outward for a while; this usually recovers. Swelling and bruising are most visible in the first week or two.

What is orbital decompression?

Orbital decompression makes more room in the orbit. The surgeon removes part of the thin bony walls, some of the fat or both. The swollen tissue can then expand into the neighboring sinuses or toward the side of the head, and the eye moves back.

The operation is used mainly in thyroid eye disease, also called Graves' orbitopathy. In this autoimmune condition, the fat and muscles in the orbit swell and later scar. Up to 4 in 10 people with Graves' disease have some eye involvement. About 6 in 100 have a moderate-to-severe form, and about 1 in 200 a form that threatens sight.

When is decompression needed?

There are two situations:

• Urgent decompression protects sight. It is done when swollen muscles squeeze the optic nerve and very high doses of steroids given into a vein do not restore vision within 1–2 weeks. It is also used when the cornea is badly exposed, or when the eye is pushed out in front of the lids. After decompression for optic nerve compression, vision improved in 82–88% of patients in published series.
• Planned decompression treats a bulging eye, irritation from exposure and a feeling of pressure. It is done only when the disease has become inactive and thyroid hormone levels are stable.

Doctors measure activity with the Clinical Activity Score. It gives one point each for pain behind the eye, pain on eye movement, redness of the lids, redness of the white of the eye, swelling of the lids, swelling of the membrane over the white of the eye and swelling at the inner corner. A score of 3 or more out of 7 means the disease is active. The active phase usually lasts about 6–18 months.

Which treatments come before surgery?

Everyone with thyroid eye disease benefits from stopping smoking and from keeping thyroid hormone levels normal. Mild active disease is often treated with selenium tablets for 6 months. Active moderate-to-severe disease is treated with steroids given into a vein over 12 weeks, often combined with mycophenolate, an immune-suppressing medicine.

Newer medicines block the insulin-like growth factor 1 (IGF-1) receptor. In trials of teprotumumab, bulging decreased in 77–83% of patients, compared with 10–15% on placebo; hearing and blood sugar need monitoring. It was authorized in the European Union in June 2025. Veligrotug-vvze (Lumvoa) was approved in the US on June 26, 2026. As of September 2026, the availability of both differs between countries. Radiotherapy to the orbit is an option in selected cases. These treatments are given by endocrinologists and other specialist teams.

How is decompression done, and how far does the eye move back?

Most incisions are hidden inside the lower lid, at the inner corner of the eye or in a skin crease. Surgery on the inner wall through the nose is done together with ENT surgeons. When both eyes need decompression, they can be operated on at the same time or one after the other.

The choice depends on how far the eye bulges, the shape of your orbit, the state of the optic nerve and the risk of double vision.

What are the risks of decompression?

According to a UK hospital leaflet, about 10–15% of patients need prisms or eye-muscle surgery for double vision after decompression.

What is recovery like after decompression?

Avoid swimming for about 4 weeks, and do not drive while you see double. If you come from abroad, book your return flight at least 3 weeks after decompression that opened the sinuses, and confirm it at the check-up.

Orbital surgery in Antalya

Prof. Dr. Elif Betül Türkoğlu performs orbital surgery in Antalya, Türkiye: orbital biopsies, removal of orbital tumors and orbital decompression for thyroid eye disease. She is a professor of ophthalmology and an ocular oncologist, and a member of the American and European societies of ophthalmic plastic and reconstructive surgery (ASOPRS and ESOPRS). Approaches through the nose or the skull, radiotherapy and medicines are planned together with the relevant specialist teams.

If you live abroad, start by sending your MRI and CT as original DICOM files, recent thyroid blood tests, reports of earlier treatment and photos of your face from earlier years. After a biopsy or tumor removal, the length of your stay depends on the operation and on when the pathology result is needed. Consultations are in English or Turkish. If needed, BergemHealth, the practice's international patient coordination partner, provides an interpreter and a personal escort who speak Ukrainian and Russian. See international patients.