Hyperthyroidism is a relatively common eye lesion in patients with hyperthyroidism, and can be classified as simple proptosis (or benign proptosis) or infiltrative proptosis (or malignant proptosis). The onset of hyperthyroidism does not necessarily parallel the onset of hyperthyroidism itself. Some proptosis occurs before the onset of hyperthyroidism symptoms, some occurs at the same time as hyperthyroidism, and some patients develop proptosis after the hyperthyroidism has resolved. The diagnosis of hyperthyroidism proptosis is generally not difficult. The diagnosis can be made by combining the symptoms and signs of hyperthyroidism, positive autoantibodies to the thyroid gland, and swelling of the eye muscles detected by ultrasound or CT or MRI. Once the diagnosis of hyperthyroidism is confirmed, the key is the timely selection of a treatment plan. A suitable treatment can relieve the pain of patients with hyperthyroidism, while an inappropriate treatment plan or delay in treatment often aggravates the disease and misses the best treatment time. Generally speaking, the treatment of hyperthyroidism proptosis mainly includes the following points: a. Protective treatment measures mainly include rest for the eyes, sunglasses can be worn to avoid bright light and other stimuli when there are symptoms of eye irritation such as photophobia and tearing; if the eyes are not fully closed, antibacterial eye ointment should be applied before bedtime and eye shields should be worn to avoid exposure of the cornea to protect the conjunctiva and cornea; high pillow position, control sodium intake, diuretics can be used, local Antibacterial eye drops and cortisone eye drops can be used; 1% methylcellulose eye drops or artificial tears are more effective in reducing the symptoms of eye irritation. There is clear evidence that smoking can worsen proptosis, that smoking affects the effectiveness of proptosis treatment, and that the effectiveness of proptosis treatment is better in those who quit smoking than in those who do not. Therefore, patients with hyperthyroidism with proptosis must quit if they have a smoking habit. For non-smoking hyperthyroidism proptosis patients should also avoid passive smoking. Glucocorticoids and other immunosuppressants Adrenal glucocorticoids such as prednisone and methylprednisolone have clear efficacy in the treatment of hyperthyroidism proptosis, but some clinical patients with hyperthyroidism have reported that the effect of hormone therapy is not satisfactory. In fact, the key to effective hormone therapy for hyperthyroidism is early treatment and adequate treatment. Early treatment means that treatment must be carried out during the inflammatory phase of hyperthyroidism. Some patients use smaller doses of hormones to treat their synostosis, which often results in side effects of hormones without improvement. Hormone treatment for hyperthyroidism can be oral hormone or intravenous hormone, and intravenous hormone is recommended. Oral hormones tend to have more side effects and are less effective than intravenous hormones. Sometimes, when glucocorticoids are not very effective, other immunosuppressive agents can be added, commonly cyclophosphamide. Of course, before using hormones or cyclophosphamide must be ruled out whether there are contraindications to the drug. Growth inhibitor analogues Growth inhibitor analogues such as octreotide can inhibit the release of cytokines in the orbit of patients with hyperthyroidism proptosis and inhibit the activation of endothelial cells and fibroblasts, so they can be used for the treatment of hyperthyroidism proptosis. It can be tried for patients who have poor results with glucocorticoid therapy or are not suitable for glucocorticoid use. The use of octreotide can significantly reduce the inflammatory response in the soft tissues of the eye and improve symptoms, but the anti-inflammatory effect is less than that of glucocorticoids. The use of growth inhibitor analogs should also pay attention to side effects, such as the possibility of causing more serious gastrointestinal reactions, and for diabetic patients may cause blood sugar fluctuations, hypoglycemia, etc. V. Orbital radiation therapy The efficiency of orbital radiation therapy for hyperthyroidism is about 60%, and this therapy can be applied alone or in combination with glucocorticoids, and the combination can increase the efficacy. Orbital radiation therapy is more effective for ocular soft tissue changes and optic neuropathy and recent extraocular muscle involvement, but it is less effective in reducing protrusion and improving eye muscle activity, especially in patients with proptosis who have had extraocular muscle involvement for a long time. The therapeutic effect of orbital radiotherapy usually takes several days to weeks to appear. Diabetic and hypertensive retinopathy and those younger than 35 years old are contraindications to orbital radiation therapy. The surgical treatment of hyperthyroidism proptosis mainly includes orbital decompression and oculoplastic surgery. Orbital decompression is an effective treatment for severe hyperthyroidism proptosis, mainly for hyperthyroidism proptosis causing exposed corneal ulcers, and optic neuropathy caused by compression of the optic nerve by the extraocular muscles, resulting in visual field defects and vision loss. Oculoplastic surgery also includes extraocular muscle surgery and eyelid surgery. Extraocular muscle surgery is used for the treatment of hyperopic diplopia. Successful surgery can reduce the diplopia and reduce or eliminate the diplopia. Eyelid surgery is indicated for patients with one or both receding eyelids, large lid fissures that require surgery to improve their appearance, incomplete eyelid closure, foreign body sensation, and keratitis. In conclusion, the treatment of hyperthyroidism proptosis must be based on the actual situation of each patient and a reasonable treatment plan must be developed. For patients with proptosis in the active inflammatory phase, it is important to make an immediate decision and not to look ahead and lose the best treatment time because of the side effects of hormones and other drugs.