Graves orbitopathy (GO) or thyroid eye disease (TED) is an autoimmune condition most common in people with hyperthyroid Graves disease. Severe GO may cause blindness due to optic compression following expansion of the orbital contents. In many patients, the persistent disfigured appearance of the eyes is a source of significant psychological distress and effective treatments are lacking. This has driven efforts to identify novel therapeutic options resulting in progress in our understanding of the tissue remodelling processes underpinning GO. In this lecture, I will describe briefly clinical aspects of GO including signs and symptoms and risk factors. I will explore GO pathogenesis including target autoantigens, regulation of tissue remodelling and tolerance mechanisms. I will also summarise recent trials of non-immunosuppressive therapies in GO.