Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disorder of the orbital adipose, connective tissues, and extraocular muscles. Approximately 25-50% of patients with Graves’ disease develop GO and report symptoms of GO including dry eye, photophobia, excessive tearing, and double vision. The most common clinical manifestations of GO include upper eyelid retraction, periorbital edema, conjunctival chemosis, proptosis, and restrictive extraocular myopathy. Although the majority of patients with GO experience mild ocular symptoms, 3 to 5% of patients suffer severe symptoms including intensive pain, inflammation, and sight-threatening corneal ulcer or compressive optic neuropathy.
　　The management of GO include orbital decompression, strabismus surgery and lid retraction correction. Although the technique of orbital decompression continues to evolve, postoperative diplopia remains a significant complication in all such procedures.? Inferomedial wall decompression, even when it leaves an intact strut of bone at the maxillary-ethmoidal junction, continues to carry a significant risk for consecutive diplopia and globe displacement. ?Previous reports indicated that extensive removal of orbital fat may reduce proptosis with few complications. It is increasingly popular for oculoplastic surgeons to remove orbital fat to rehabilitate patients with cosmetically disfiguring exophthalmos, exposure keratopathy and even compressive optic neuropathy. The advantages of fatty decompression include preservation of the orbital wall and less surgically-induced diplopia.
　　In this presentation, I will talk about the clinical manifestations of GO and discuss new concept for the management of GO.