Most patients with thyroid eye disease will have relatively few symptoms and signs, and many will require only topical lubricants during the active phase of the disease and no long-term therapy. Patients without proptosis when the disease is inactive, but with persistent lid retraction or incomplete lid closure, may need eyelid surgery to protect the cornea (Chapter 7). Likewise, squint surgery may be needed when the eye disease has been shown to be stable and inactive for some months.
Management of more severe and significant thyroid eye disease should be first directed towards suppression of orbital inflammation and later the restoration of orbital function.
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