Although Graves ophthalmopathy is a potentially sight threatening and disfiguring condition that can be frightening for the patient to experience, there are effective means of management. At the present time, treatment is based on the relief of excessive intraorbital pressures and is accomplished either by shrinking the orbital contents or by expanding the orbital volume. The most effective treatment modality or combination of modalities is an area of controversy. However, it must be remembered that the approach to management undertaken should be finely tuned to the needs of the particular individual afflicted with the condition. Perhaps with a greater understanding of pathophysiology, more reliable and effective treatments, based on specific pathophysiological mechanisms, may be developed. In addition, tests to reliably predict those patients most likely to progress in their disease might be developed, allowing preventive measures to be taken.