Abstract: Thyroid-associated ophthalmopathy associated with autoimmunity is a disease of inflammatory infiltration of periorbital and intraorbital ocular tissue caused by multi-factor disorders, but the pathogenesis has not been elucidated. The ocular damage caused by TAO has a wide range of involvement, and the ocular surface damage has a significant impact on visual function. The enlargement of palpebral fissure, the lesion of meibomian gland, the dysfunction of meibomian gland and the decrease of lipid layer of tear film caused by TAO lead to excessive evaporation of tear and the change of high osmotic pressure of tear, which induces or aggravates ocular surface inflammation. The abnormal expression of inflammatory factors in tears and the pathological changes of main and accessory lacrimal glands, and the decrease of water layer led to the further increase of tear osmotic pressure. The vicious circle of inflammation causes the damage of keratoconjunctival barrier, the decrease of corneal nerve fiber density and the decrease of corneal sensitivity. The changes of corneal biomechanical properties and the decrease of deformability in patients with TAO affected the measurement of intraocular pressure. TAO is also accompanied by orbital tissue hyperplasia and expansion, and the orbital pressure increases in patients, which lead to the disturbance of blood circulation. The nutritional supply of the ocular surface is impaired, and the normal physiological function of the ocular surface including the secretion of mucin by conjunctival goblet cells is affected. Ocular surface damage caused by TAO causes a series of serious eye discomfort and facial damage, which threatens the physical and mental health of patients. (Int Rev Ophthalmol, 2023, 47: 354-359)

Key words: thyroid-associated ophthalmopathy, ocular surface damage, inflammation