The efficiency of internal orbital decompression was evaluated in uncompensated edematous exophthalmos (EE). Twenty-two patients aged 17-65 years who had EE (30 orbits) were followed up. EE in a subcompensation and decompensation stage occurred in 12 (17 orbits) and 10 (13 orbits) patients, respectively. When glucocorticoid therapy was ineffective, internal orbital decompression was made in order to preserve visual functions. Surgery was performed via transconjunctival approach (Brovkina, 2004). After surgery, exophthalmos diminished by an average of 4.6 and 5.6 mm in a subcompensation and decompensation stage, respectively. There was a substantial reduction in periorbital tissue edema, in conjunctival changes, corneal opacity, and optical neuropathy to the extent of complete regression. Internal orbital decompression is effective in uncompensated forms of EE, as appeared as a significant alleviation of its clinical symptoms and as preserved or increased baseline visual acuity.