Surgeries for thyroid eye disease include orbital decompression (to relieve swelling), strabismus (to repair eye muscles and correct eye alignment), and eyelid retraction correction (to restore eyelid coverage).

Thyroid eye disease (TED) occurs in around around 40% of people with Graves’ disease.

Depending on the type of TED you have and the severity of your symptoms, different treatments are available. Surgery may be needed if TED is affecting the function or structure of your eyes. For example, surgeries can correct symptoms like:

  • swelling of your eyelids or eyeballs
  • pain with eye movement
  • pressure on your optic nerve

This article takes a closer look at the different types of surgeries that are available for TED and what to expect for each.

Excessive swelling behind your eye can put pressure on your optic nerve and affect your vision. Your eye may even get pushed forward in the socket, and you may experience double vision.

In orbital decompression surgery, a surgeon will remove bone or fat from behind your eye to create more space for your eye.

This will reduce the pressure on your optic nerve, protecting your vision. It also allows your eye to return to its proper position in the socket.

Recovery timeline

This surgery happens under general anesthesia. The use of minimally invasive techniques has helped shorten recovery time.

The cuts made in this surgery are hidden, and there’s no visible scarring. You’ll likely be able to return to normal activities within 1 to 2 weeks.

Side effects

Orbital decompression doesn’t always improve double vision. And in some cases, double vision starts to occur after orbital decompression.

Eye muscle surgery or wearing glasses with a prism can help manage double vision.


The cost of the surgery will vary depending on your individual case and where you have it performed.

For many people with TED, this surgery is required for medical reasons. In which case it’s typically covered by insurance.

Outlook for people who’ve had this surgery

Orbital decompression surgery improves your eye’s appearance and function.

If other eye surgeries are needed, orbital decompression surgery is done first. Usually, surgeries are 2 to 4 months apart to allow time to heal in between.

The damage from active TED can cause scar tissue to build up on your eye muscles. Scar tissue can shorten eye muscles and limit movement of the eye, resulting in misalignment.

Strabismus surgery fixes this. During the procedure, a surgeon cuts damaged muscles, then reattaches them to your eye.

This returns your eyes to their correct position and restores a normal range of movement.

Recovery timeline

This surgery is typically done under general anesthesia.

Stitches used to reattach the muscle will dissolve in about 6 weeks. You’ll likely be back to normal activities within 1 or 2 weeks.

Side effects

It’s normal for eyes to be red, irritated, and watery for a few days as you recover from surgery.

Double vision may be present after surgery as well, as your brain adjusts to the new positioning of your eyes. This will improve over the days and weeks to come.


The cost of this surgery will vary depending on your individual case and where you have it done. It’s typically covered by insurance if it’s needed to correct vision and eye position.

Outlook for people who’ve had this surgery

This surgery can be quite effective for treating double vision.

You may be given some eye strengthening exercises to help with recovery. You may also need to continue wearing glasses with a prism during the recovery phase.

In some cases, follow-up surgery is needed.

TED can cause muscles and fatty tissue behind your eye to swell. This can push your eye out of position.

In some cases, your eyelid is no longer able to cover the whole eye. When your eyelid can’t close all the way, the exposed part of your eye becomes very irritated.

Eyelid retraction surgery adjusts the position of your eyelid so that it can close over your entire eye.

Recovery timeline

This surgery is done under general anesthesia.

Eyelid surgery is delayed until TED is stable, however. This means that if other surgeries are needed, those are done first.

Your eye needs to be back in proper position before eyelid retraction can be done.

You’ll likely be back to your normal routine in 1 or 2 weeks after eyelid retraction surgery.

Side effects

It’s normal for your eyes to be red and sensitive for a few days. There may be some bruising or swelling as well. Your eyelids may be red for longer but will improve in the weeks to come.


As with the other surgeries, many factors will influence the price. Your insurance is likely to cover the cost of this surgery when it’s performed as part of treatment for TED.

Outlook for people who’ve had this surgery

Advances in this surgery are making it less invasive, with better results.

Having your eyelid back in the proper position relieves irritation of the eye. It can also help you feel and look more like your before-TED self.

Will my eyes go back to normal after a thyroidectomy?

Thyroid eye disease (TED) is typically associated with hyperthyroidism or Graves’ disease. After hyperthyroidism or Graves’ disease is corrected, either through a thyroidectomy or other means, your eyes won’t always go back to the way they were before TED.

In certain cases, your eyes may worsen in the months or years following treatment, despite the stabilization of thyroid hormones. Talk with your doctor about what you can do to relieve your eye symptoms. Surgery is one option, but there may be others.

What is the success rate of thyroid eye surgery?

A 2022 study examined the safety and effectiveness of orbital decompression combined with strabismus surgery in thyroid-related eye disease. Of the 52 people in the study that were treated with these surgeries, 44 (or 84.6%) achieved surgical success, according to the criterion set out in the study.

Another 2022 study that looked at 95 surgical eye procedures for TED found that 57% (45 people) had excellent outcomes, 29% (23 people) had good outcomes, and 14% (11 people) had poor outcomes.

Can I drive with thyroid eye disease?

Whether you should drive with thyroid eye disease (TED) depends on how advanced the disease is and your symptoms. You may have no difficulty driving in the early stages of the disease. However, later-stage symptoms, such as double-vision, may prevent you from driving safely.

As part of thyroid eye disease (TED) treatment, three surgeries that may be done include:

  • orbital decompression
  • strabismus (eye muscle) surgery
  • surgery to address eyelid retraction

Not everyone with TED will need surgery. You and your doctor can work together to decide the best treatment choices for you. In recent years, advances in surgical techniques have improved outcomes.