TED Surgery FAQs

Most Common TED Surgery FAQs

What are the benefits of decompression surgery?

If you are a candidate for surgery, it will improve pain and pressure behind the eyes, eye bulging (proptosis), dryness, light sensitivity and vision if associated with dryness or optic neuropathy. Additionally, it will restore your self-confidence and social interactions.

Is there anything the decompression surgery will not improve?

Double vision.

What is the chance for symmetry?

The chance for symmetry is very high in most case as we concentrate on achieving uniformity of the eye position, the eyelid height and all of the surrounding tissues. We take a very comprehensive approach to achieve the ideal result for both function and appearance.

Will it help my eye pain and pressure?

Yes, Dr. Douglas performs a specialized technique to decompress the nerves that causes pain and pressure behind the eye. During the initial evaluation, we take time to investigate this process and how we can offer improvement. Our studies have shown a 90 percent improvement in patients for their pain and pressure.

Does the thyroid affect vision?

Yes, Thyroid can affect vision due to having dry eyes. Also, the optic nerve can be squeezed which can cause double vision in addition to being painful.

Can thyroid eye disease cause glaucoma?

Yes, thyroid eye disease can cause glaucoma as those with thyroid tend to have high eye pressure.

Surgical Approach to TED Surgery

Can you perform surgery on both sides at the same time?

Yes, this is possible and very common. We try to reduce the number of surgeries to rehabilitate you faster!

Do you use an endoscope?

No, we have techniques that do not use an endoscope but provide direct access to the orbit. The endoscopic approach is possible but requires removal of normal sinuses and is usually less effective.

Does removing bone cause problems?

Using the minimally invasive and customized approaches we have developed; the removal of bone does not cause any significant problems or risk injury. Many people are born without the bones that are shaved so it does not seem to cause any increased risk or problems. However, endoscopic approaches, which we do not perform, can cause sinus problems.

Where is the incision for a decompression surgery?

The incision is ALWAYS hidden and small. We use specialized techniques for minimally invasive surgery to use small incisions. For many patients, there is no skin incision but, at most, there will be an incision in the upper eyelid about an inch long in the eyelid crease but is almost never seen.

In Asian patients is incision hidden?

We have created special techniques for Asian patients to hide the incisions and create an aesthetic decompression. Asian patients require modified techniques to achieve optimal result. We have performed countless of these procedures and, in fact, have a practice in Shanghai, China devoted to this care.

TED Surgery Risks

What is the chance of vision loss?

With any surgery around the eye, there can be risk for vision loss. However, this is very rare and we are extremely careful to mitigate all of the associated risks.

What is chance of double vision after surgery?

The rate of double vision is highly dependent on several factors—most important the size of muscles and severity of disease.  Our rates of double vision are a fraction of what is reported in the literature because we have modified each step of the process and do several hundred decompression surgeries per year.

Can double vision be corrected?

Double vision, if it occurs from the disease or surgery, can be fixed in straight ahead view in 99 percent of the cases.

What is chance the disease will come back or I will need additional surgery?

It is unusual for the disease to return; however, the life time risk for non-smokers is between three (3) to four (4) percent.


Will there be bruising and swelling following surgery? If so, how long and what severity?

Bruising will be under the eyes and there will be substantial swelling and bruising for approximately two (2) weeks.

Will I see an immediate result?

Yes, but there will be swelling so final result will be more apparent after the swelling subsides.

How much pain will I experience after surgery?

There will be discomfort but severe pain is uncommon.

Will there be patches after surgery?

No, there will not be any patches covering the eye after surgery.

How happy are patients?

Patients are typically thrilled with the procedure. Before surgery, we have an extensive discussion to determine if it is right for you and whether it will achieve your expectations.  A majority of our patients are extremely pleased with the results and often talk to other patients about their positive experience.

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