The orbit contains, protects, and supports the eye and surrounding structures, including the nerves, blood vessels, muscles, and glands. The orbit is encased in 7 bones that provide structural support and protection. Orbital diseases can be benign or malignant, and include inflammatory, vascular, structural, or neoplastic disorders.

Signs of orbital disease include proptosis (protrusion of the eye), double vision, pain, swelling, pain with eye movement, dilated blood vessels, and masses around the eye and eyelids.

The goal of an orbital evaluation is to identify the cause of the condition and its location, including systemic causes (e.g. tumor metastasis or inflammatory disease).

Dr. Kahana has unparalleled expertise in the unique field of orbital disease, with dozens of manuscripts and book chapters published, and dozens of lectures given throughout the United States and internationally. He is the busiest orbital surgeon in the Midwest, one of the busiest in the world, often performing >10 orbital surgeries per week.

Thyroid Eye Disease

  • Orbital Decompression Surgery
  • Upper Eyelid Retraction Repair (Blepharotomy)
  • Lower Eyelid Retraction Repair With Or Without Ear Cartilage Graft

This patient underwent staged bilateral lateral and bilateral medical orbital decompressions, followed by bilateral lower eyelid retraction repair with ear cartilage graft and transposition tarsorrhaphy. Post op 2 weeks after lower eyelid surgery.

Left lateral orbital decompression. Post op at 1 year.

This woman underwent urgent orbital decompression for worsening thyroid eye disease with compressive optic neuropathy. Her pain, vision loss and appearance all improved following surgery. Post op at 6 months, without any additional eyelid surgery.


This patient with severe thyroid eye disease presented to Dr. Kahana after having had multiple orbital, strabismus and eyelid surgeries over the course of a decade. She was told nothing more could be done. She was suffering from severe exposure, irritation, tearing, double vision, poor vision and facial deformity. She underwent repeat staged orbital decompression surgeries, followed by repeat strabismus and eyelid surgeries. Her eyes are now comfortable, her tearing resolved, and her vision improved, although she still has double vision (tilt), which she treats with prism glasses and monocular occlusion. She is very pleased with the results.


This patient presented with thyroid eye disease causing proptosis, swelling, pain, double vision and compressive optic neuropathy. She underwent bilateral orbital decompression. No eyelid or strabismus surgery was done. Post op is at 9 months.


This patient presented with thyroid eye disease, with proptosis, swelling and eye pain. He underwent bilateral lateral orbital decompression. There was no eyelid surgery performed. Post op is 2 months.


This patient underwent orbital decompression, strabismus and eyelid surgeries in a staged fashion. The most important surgery was the decompression surgery, because she had compressive optic neuropathy and was losing vision.


This patient presented with thyroid eye disease and left upper eyelid retraction. She underwent left upper eyelid retraction repair via a posterior approach (no skin incision). Post op is at 6 months.

Additional Orbital Diseases

  • Orbital Fracture Repair
  • Orbital Tumor/Masses Excision Or Biopsy
  • Orbital Cellulitis Management
  • Dacryoadenitis Management