Thyroid-related ophthalmopathy is one of the most common orbital diseases in adults and is an autoimmune disease, the exact pathogenesis of which is unknown. The basic force of venous return is the pressure difference between the small veins (also known as peripheral veins) and the vena cava or right atrium (also known as central veins). An increase in pressure in the small veins or a decrease in pressure in the vena cava favors venous return. Because of the thin venous walls and low venous pressure, venous return is also influenced by external forces such as muscle contraction, respiratory movements, gravity, etc. When these factors impede venous return, the body will show various manifestations. What is the diagnosis of orbital venous reflux disorder symptoms? 1.Diagnosis based on characteristic manifestations For example, the typical eyelid signs such as good bilateral onset, protrusion of the eyeballs, eyelid recession, late fall of the upper eyelid, and restricted eye movement disorders (thyroid disorder history is for reference only). Even if the thyroid gland is normal, a diagnosis of thyroid-related ophthalmopathy can still be made with close testing of thyroid function if the above-mentioned signs are present. In a small number of patients with thyroid-related ophthalmopathy, ptosis should be examined for the combination of myasthenia gravis, both of which are immunologic disorders that can occur together, and for which glucocorticoids and immunosuppressants are effective. 2. Ultrasound Ultrasound can show a thickened pattern of extraocular muscles in the shape of a shuttle with moderate to low echogenicity. 3.CT scan Coronal CT can show the thickening of each extraocular muscle, and even the upper and lower oblique muscles can be involved in a few patients. Axial CT can better show the thickening of the internal and external rectus muscles, the thin bone of the inner orbital wall, and the long-term orbital pressure elevation, resulting in the arcuate depression of the bone toward the septal sinus, which is symmetrical bilaterally, called the “coke bottle” sign. In severe cases of eye protrusion, the optic nerve is stretched and loses its physiological curvature and becomes straight. 4.MRI examination In addition to showing the same morphological changes as CT scan, the signal changes of extraocular muscles have some correlation with treatment. If T2WI shows medium or low signal, it indicates that the muscle fibrosis is serious, and hormone shock therapy, chemotherapy or radiotherapy is not known; if T2WI shows high signal, it indicates that the muscle is in inflammatory edema stage, and the above treatment is relatively sensitive. Disease in the acute progressive stage or active fraction CAS ≥ 4, feasible glucocorticoid shock therapy, specific program: according to 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 mellitus, 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 to systemic application of glucocorticosteroids, 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.