This chapter discusses orbital decompression, where Graves’ disease is a syndrome composed of diffused thyroid enlargement, palpitations, and exophthalmos. Graves’ disease results from autoimmune hyperstimulation of the thyroid-stimulating hormone (TSH) receptor in the thyroid gland. Graves’ ophthalmopathy is characterized by an intense local lymphocytic reaction. The deposition of glycosaminoglycans and ensuing edema leads to enlargement of orbital fat and extraocular muscles. The most common symptoms of Graves’ ophthalmopathy include eyelid retraction and periorbital edema. Lid retraction, chemosis, and eyelid edema tend to improve most consistently over the course of 1 to 5 years. The initial manifestation of increased intraocular pressure includes conjunctival chemosis, periorbital edema, photophobia, and increased lacrimation. Mild ophthalmopathy is usually a self-limited disease requiring only local measures to provide symptom relief.