It was thought reactivation of TED was rare after burnout, but they are finding it to be more common than previously thought. It usually happens after eye or facial surgery, including orbital decompression, strabismus surgery, cataracts, etc. or being hyperthyroid. It happened to me twice, both times a month after eyelid reconstructive surgery. The second surgery was even done while on a week course of high dose steroids in hopes of preventing it, but it still happened a couple of weeks later. Fortunately, my eye surgeon knew what was happening and started me on a two week course of high dose Prednisone and my symptoms resolved in two days. The first time it was extreme dry eye type pain, like acid in your eye, and the second was increasing diplopia. As I had already had bilateral ODs, there was plenty of room for any additional swelling in the orbit. Usually, high dose steroids immediately will take care of recurrence after burnout, especially if your initial disease was severe, but be aware that this can happen so you dont let it get out of hand. My surgeon explained that TED can “simmer”, not completely go away. I was told by another surgeon that one reason to have ODs even if proptosis is not bad is to prevent having to redo lid or strabismus surgery if it recurs, but I do not know if this is true. At any rate, I was glad it was stopped immediately. Bottom line, do not ignore worsening symptoms after surgery.