Thyroid Eye Disease


Cosmetic Orbital Decompression

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Learn about the molecular basis, diagnosis, symptoms, and latest treatments for the disease.  


Thyroid Eye Disease

Thyroid disease can be life-altering when it affects the eyes, as it typically becomes active at the age when patients are getting married, advancing in their career, and planning their life goals. This disfiguring and debilitating condition needs close follow-up and expert treatment by an experienced orbital specialist to ensure an optimal outcome. Our goal is to help you achieve the function and cosmetic appearance you had before the onset of disease.

Blood Test

How do I know if I have thyroid eye disease?

Thyroid eye disease can present even before thyroid abnormalities show in your bloodwork. It can affect eye muscles, soft tissue, or eyelids most commonly. Typical symptoms include bulging eyes, double vision, dry eye, pain behind the eyes, swelling and puffiness around the eyelids and eyebrow, and in extreme cases, vision loss. If you have any of these symptoms, you should be evaluated promptly to determine if thyroid eye disease is the cause of your condition. A thorough history and clinical examination, along with bloodwork or a CT scan, is helpful in making the diagnosis. Most patients develop TED within 12 months of diagnosis of their systemic thyroid illness.

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Bartley et al. 1994

What are the available treatments?

Different aspects of thyroid eye disease require different solutions. In the initial active or inflammatory phase, medicines, specialized prismatic glasses, and injections can be helpful. Dr. Ramesh was involved in the testing and development of next-generation immunotherapy (Tepezza) to treat particularly difficult cases of thyroid eye disease. After the disease has stabilized, surgery to reduce double vision, reduce bulging of the eyes, or restore the cosmetic appearance to what it was before the onset of disease can be considered.


Surgery must be customized to your condition, and there is no “one-size-fits-all” approach. We will carefully listen to your concerns, and together, you will design a plan to address your particular problems. We also encourage you to bring old photos, to understand your facial structure before the thyroid eye disease started.

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Surgeons in Operating Room

What is orbital decompression?

Orbital decompression is a surgery for patients with naturally prominent or bulging eyes. This can improve the aesthetic appearance of the eyes and any symptoms of dryness, light sensitivity, or tearing. Dr. Ramesh is a world expert in this challenging surgery and has published multiple scientific articles and book chapters on the subject. Most importantly, he has a passion for taking care of patients with thyroid eye disease and providing relief from their medical and cosmetic symptoms.


Health insurance typically covers the majority of the rehabilitative treatments associated with thyroid eye disease. Please schedule a consultation so that we can check what your insurance will cover.

What can I expect afterwards?

Surgery may be performed under general or twilight anesthesia. Patients can have bruising and swelling around the eyes for 1-2 weeks, with minimal pain. Patients are typically ready for formal social functions within 6 weeks.


Our goal is for you to regain the appearance and function you had before the onset of thyroid disease, as much as possible. Having cared for many patients with this condition, Dr. Ramesh looks forward to using his extensive experience to help you through this challenging time and onwards to your future.

Smiling Woman

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35 Clyde Road, #104

Somerset, NJ 08873

phone: 609-608-0142

fax: 855-644-0469