The diagnosis is made clinically as stated above. Orbital CT is used in conjunction to confirm the diagnosis. Asymmetric presentation of thyroid ophthalmopathy may mimic an orbital tumor. Axial CT through the enlarged inferior rectus muscle may suggest a retrobulbar mass. A coronal CT will clarify that proptosis is a result of the enlargement of the inferior rectus.
Treatment is dependent on the severity of the disease.
If mild, the patient may be treated with topical lubrication and patching at night. If in the acute phase, the patient may require systemic corticosteroids or immunosuppressive agents. Orbital surgry may be required for the lower lid retractors. Orbital decompressive surgery is an effective treatment for compressive optic neuropathy. Traditionally this was done by removing the medial orbital wall along with the orbital floor.