Thyroid eye diseaseThyroid eye disease (TED) is an auto-immune condition characterised by an acute inflammatory phase followed by a fibrotic phase which sometimes leads to restricted eye movements and diplopia. Medical treatment with systemic steroids with or without orbital radiotherapy and immunosuppression can control the inflammatory response. StrabismusStrabismus surgerySurgery should be carried out only after the inflammation is no longer active and after any decompression surgerySurgery. SurgerySurgery comprises recession of tight muscles using adjustable sutures so as to maximise the area of binocular single vision. There is debate as to whether adjustable sutures should be used for the inferior rectus muscle. Patients should be encouraged to have realistic expectations since binocular single vision (BSV) may not be achievable in all directions of gaze and lid retraction may be made worse by surgerySurgery.