Thyroid eye disease is an autoimmune condition, usually associated with Graves’ disease and less often with hypothyroidism and euthyroidism. Patients with thyroid eye disease typically experience inflammation and swelling around the eyes. Only about 5 % of patients with Graves’ disease develop thyroid eye disease that is severe enough to require medical attention. For those severe cases, the surgeon will generally recommend medical treatment first and then surgical treatment, such as orbital decompression surgery, muscle surgery, or eyelid surgery, to alleviate the dry eye or double vision and restore normal appearance. In rare instances, emergent surgery is necessary to save vision from severe compression of the optic nerve or corneal exposure and decompensation.

Orbital decompression is a surgery to enlarge the eye socket, thus reducing the pressure on the optic nerve and the bulging of the eye (proptosis). It involves removing orbital fat, bone or both. It is done in the operating room under general anesthesia. Patient may be observed over night in the hospital and discharged the next morning.

Most patients with thyroid eye disease require multiple surgeries before restoring normal or near-normal appearance. This all depends on the severity of the disease. Of the risk factors related to thyroid eye disease, smoking is a strong and important factor, as it can be controlled.