Post count: 305

I had severe Graves ophthalmopathy and have had OD surgery both eyes, strabismus surgery and lids. Double vision is not at all uncommon with orbital decompression and most likely if done through the nose or by the inner corner. While going in through the outside corner (lateral) is least likely to result in double vision, I did have a huge worsening of the double vision I already had going into the surgery. This was due either to nerve damage or a hematoma and it did resolve to my presurgery degree of double vision.

Several things. First, TED can and does recur even years later. Without OD, you can end up with very little space in your orbits as the eye muscles swell and stiffen. Should it recur or worsen, you could end up with optic neuropathy which is potentially blinding. So do not regret your choice to have it done.

Strabismus is the inability of muscles to work together and in our case it is due to scarring and fibrosis of the muscles and compression of the muscles within the orbit due to swelling. They literally cannot move well and the OD helps with the space restriction which can damage the optic nerve and cause glaucoma. Once more space becomes available, the muscles tend to shift to fill the space, alleviating pressure but also malpositioning the eyes also causing diplopia.

If your issue is seelling from the surgery, then yes, it could improve. Double vision can be alleviated with press on (Fresnel) prisms on your glasses if you wear them or over nonprescription glasses. Once changing stops, prism can be ground into lenses. If it is bad enough, as it was in my case, strabismus surgery can be done by a pediatric ophthalmologist. There will always be difficulty looking to the sides and down so you learn to turn your head but straight ahead single vision can be achieved through prism or surgery. I you are only bothered driving at night or in bad weather, consider yourself lucky! I still have difficulty even in daylight on expressways sometimes. Due to the stiffness of the muscles, fatigue especially can make fusion difficult.

So should you require strabismus surgery, it is an easy surgery, they do it on kids all the time. My surgeon did the lateral approach because his patients were not happy with the double vision resulting from the nasal approaches, so it is not rare by any means but the OD surgery can be sight saving.

I was fortunate to see a oculoplastic surgeon known worldwide for his Graves expertise. If you live near a teaching hospital or an eye center like Kellogg in Michigan or Bascom Palmer in Florida or Emory in Atlanta,for example, go there. In the meantime, you might see an optometrist for a prism prescription.

TED is not an easy disease nor is it predictable. I had a total thyroidectomy, then intravenous steroids, orbital radiation, and after it burned out, ODs, strabismus surgery and lastly 3 lid repairs per eye. And I have had one recurrence fortunately easily treated with oral prednisone.

Patience is truly necessary with TED. Healing takes longer and nothing can be rushed. So wait to see if there is improvement first. Then find the most experienced opthalmologists you can even if it involves traveling. The most important is the oculoplastic surgeon. Do not second guess the OD. It is necessary for most of us with TED, either at initial occurrence or later. The strabismus is mostly fixable, even though the stiff, fibrosed muscle caused by attacking antibodies are not and they sometimes need to be repositioned on the eye.

I hope this makes sense. I have been through it all with TED and my husband is an ophthalmologist so I had a great source of info but even then it was a challenge.