Graves' disease can affect the eyes and orbits in many ways, some seemingly trivial, others obviously devastating to vision. Because of the relative simplicity of diagnosing Graves' disease in the majority of cases, and now with the addition of B-scan ultrasonography, much expense and needless risk is avoidable in most patients with ophthalmopathic Graves' disease. Those patients whose diagnosis cannot be confirmed by noninvasive techniques may not have Graves' disease and deserve more in-depth study.