Guo J, Li X, Ma R, et al. - Since postoperative ocular imbalance is a significant issue for orbital decompression surgery in thyroid eye disease (TED), researchers sought to assess the changes in unilateral ocular deviation and duction following orbital decompression and explain the biomechanics of ocular imbalance. Participants in the study were 54 TED patients (26 men and 28 women), mean age 51.7 ± 12.5 years (18–72 years), who underwent unilateral orbital decompression. Fifteen patients had 1-wall (deep lateral wall) decompression, 18 patients had 2-wall (deep lateral and medial wall) decompression and 21 patients had 3-wall (deep lateral, medial and inferior wall) decompression. After 1-wall, 2-wall and 3-wall orbital decompression, the changes in ocular deviation and duction were different. The increased contractile force of the rectus may play a role in strabismus changes following orbital decompression surgery.