In the treatment of severe manifestations of dysthyroid orbitopathy, such as optic neuropathy and exposure keratitis, orbital decompression occasionally may be performed if steroids fail. In general, medial and inferior orbital wall decompression gives satisfactory results. The route may be transantral, but the transconjunctival or endonasal approach may be more appropriate for extraocular muscle balance and optic neuropathy respectively.
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