Table 2.

Current management of GO

	Management
General measures for all patients with GO	Local treatments (artificial tears, ointments, dark lenses)
	Smoking withdrawal Stable maintenance of euthyroidism
Mild and active GO	Selenium supplementation for 6 months
	High-dose glucocorticoids if the quality of life is severely affected
Mild and inactive GO	Rehabilitative surgery as needed or required by the patients for cosmetic/functional reasons
Moderate-to-severe and active GO	First-line: high-dose glucocorticoids, preferably intravenously
	Second line (particularly for relapsing GO): a second course of high-dose glucocorticoids, possibly associated with orbital radiotherapy; oral glucocorticoids combined with cyclosporine
Moderate-to-severe and inactive GO	Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) as needed
Sight-threatening GO (dysthyroid optic neuropathy)	Very high doses of intravenous glucocorticoids
	Urgent orbital decompression if the response to medical treatment is poor/absent within 2 weeks