Would orbital decompression cause double vision for TED patients who are no longer in are active phase?

I was diagnosed with TED in the summer of 2014 and was told it has now stabilized. I want to consider surgery to restore my eyes as much as possible. But I was told that ODS can cause double vision and was only suggested to have eyelid repairs. But my eyes are definitely more protruding that they were before TED.

Doctor Answers 2

Thyroid orbital decompression

Once your thyroid orbital disease is stabilized, and vision presumably at a good baseline, you have two choices for the protruding appearance. You may consider eyelid surgery to bring the upper lids down over the eyeballs - which makes the eyes appear to be further back in the eye socket, or you may consider orbital decompression to allow the eyes to sink back into the sockets. Eyelid surgery generally carries less risk than orbital surgery. Often eyelid surgery is necessary after orbital decompression, and - if you do develop diplopia after surgery - you might require strabismus surgery as well. If you are otherwise healthy and are a nonsmoker, your odds are better for success without diplopia. I agree with Dr. Schiller that the risks for orbital decompression (bone, not just fat) are relatively low in the hands of an experienced Oculoplastic surgeon. Best wishes with your decisions!


Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Double vision after orbital decompression risk

Current techniques of orbital decompression are minimally invasive and are safer than ever, so the risk of double vision is much lower than before. The risk depends  on the severity of your disease, and the experience and skill of your surgeon. Some plastic surgeons only perform "fat decompression" and that is helpful in only a minority of patients. You should be evaluated by an oculoplastic surgeon who treats many thyroid eye disease patients and does orbital decompression regularly, who should be able to tell you how much risk there is for you. But the risk is never zero, however it should be uncommon. In my experience when it does occur it can be cured with a single adjustable eye muscle operation.

Jeffrey Schiller, MD
Staten Island Oculoplastic Surgeon
5.0 out of 5 stars 10 reviews

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