Patients with orbital venous reflux disorder have a good bilateral onset with protruding eyeballs, typical eyelid signs such as eyelid recession and late fall of the upper eyelid, and restrictive eye movement disorders. Even with normal thyroid function, a diagnosis of thyroid-associated ophthalmopathy can still be made with close testing of thyroid function if the above-mentioned signs are present. In the minority of patients with thyroid-related ophthalmopathy who present with ptosis, they should be examined for the combination of myasthenia gravis, both of which are immune disorders that can occur concomitantly, and for which both glucocorticoids and immunosuppressive drugs are effective. What can be done to effectively prevent and treat orbital venous reflux disorders? 1.General treatment (1)Actively adjust the level of thyroid hormone to maintain it in the normal range, and avoid sudden reduction or increase of drug dosage. (2) Avoid spicy and stimulating food, quit smoking, prevent eye fatigue, wear sunglasses in case of bright light, and avoid emotional excitement. The head is elevated during sleep and those with incomplete lid closure need to apply eye ointment or wet room protection. 2, drug treatment (1) glucocorticoid therapy disease in the acute progressive stage or active score CAS ≥ 4, the feasibility of glucocorticoid shock therapy, the specific program: according to the patient tolerance to give intravenous methylprednisolone 500-1000mg / day, shock 3-5 days, stop 7 days after the second shock can be given, repeated 3-7 times, the effect is better. Or oral high dose prednisone 60-80mg/day, gradually reduce the dose, and need to increase the dose when the symptoms recur. Complications of hormone use need to be closely observed during treatment: secondary hypertension, diabetes, stress ulcers, electrolyte disorders, liver and kidney damage, osteoporosis, pathological fractures, mental disorders, dryness and insomnia, hyperphagia and irritability, etc. For those who have contraindications for systemic application of glucocorticoids, intraorbital local injection of trimethoprim, 40mg/time, in the muscle cone or around the extraocular muscles, can be repeatedly injected several times, but care should be taken to avoid complications such as elevated orbital pressure or intraorbital hemorrhage. (2) Immunosuppressive therapy Patients who are suitable for glucocorticoid therapy can also try immunosuppressive drugs, including: methotrexate, cyclophosphamide and cyclosporine. They can also be used in combination with glucocorticoids. Complications of treatment: bone marrow suppression, liver and kidney damage, gastrointestinal disorders, infections, etc. (3) Local application of adrenergic blocking agents Early in the course of the disease, alpha adrenergic tone is increased, causing excitation of the upper and lower eyelid Müller muscles and eyelid retraction. The adrenergic blocker guanethidine sulfate ophthalmic solution can produce a chemical sympathectomy effect and alleviate eyelid regression. (4) Topical application of botulinum toxin A Botulinum toxin A is an acetylcholinergic receptor blocker that competes with acetylcholine for the cholinergic receptors that innervate extraocular muscle movements, causing extraocular muscle paralysis. It can be used for upper eyelid retraction due to levator muscle spasm and other strabismus due to extraocular muscle spasm, but the therapeutic effect only lasts for a few weeks to about six months and requires repeated injections. 3. Radiation therapy Local radiation therapy can be used for those who are not sensitive to medication, have a sharp decrease in vision, or whose systemic condition cannot tolerate medication. The total dose of linear gas pedal is 20Gy and the daily dose is 2Gy. Complications of radiotherapy include: radioactive cataract, retinopathy and carcinogenic risk, etc. A few patients can be aggravated by radiotherapy. 4.Surgical treatment (1)Eyelid recession correction Suitable for patients with severe eyelid recession, oversized lid fissures, secondary exposure keratitis or affecting appearance. Surgical options include Müller muscle resection, levator muscle lengthening, levator margin dissection, lower lid reduction and posterior migration of the capsular fascia, lid suturing and lid fissure shortening. (2) Surgical treatment of ocular myopathy Restrictive extraocular myopathy is one of the most common clinical manifestations of TAO. Inflammation, edema and fibrosis of the extraocular muscles are responsible for the loss of motor function of the muscles. The timing of surgery should be after 3-6 months of stabilization of the ocular myopathy, and orbital decompression surgery should be performed first in cases of combined high protrusion of the eye. This type of surgery is recommended to posteriorly migrate the diseased muscle and should not shorten the antagonist muscle. In severe muscle fibrosis, the Tenon bursa and perimuscular tissue should be adequately separated. (3) Orbital decompression Orbital decompression is an effective treatment for severe cases. It is suitable for those with stable hyperthyroidism control, secondary optic neuropathy requiring relief of pressure at the orbital apex, or severe protrusion of the eye secondary to exposure keratitis. This procedure is also feasible for those whose appearance is severely disfigured by ocular protrusion, after the disease has ceased to progress. Depending on the condition, one-, two-, and three-wall decompression options are available. To reduce complications such as displacement of the eye, balanced decompression of the inner and outer walls of the orbit is preferred. The surgery involves removal of the orbital bone wall and periosteum, separation of the intermuscular membrane, and herniation of the fat in the orbit, especially in the muscle cone, to achieve relief of orbital protrusion and improve visual acuity. Depending on the degree of protrusion of the eye, it is decided whether to combine lipectomy or not. (4) Lipectomy For mild degree of eye protrusion, intraorbital fat, especially intraosseous fat, can be removed through a bulbar conjunctival incision to achieve symptom relief. It has the advantages of concealed incision and minimal surgical trauma, but care should be taken to avoid complications such as intraorbital hemorrhage. It can be used in combination with orbital decompression.