Patient presents with signs and symptoms consistent with thyroid eye disease, also known as Graves ophthalmopathy or Graves orbitopathy.  Clinical findings include exophthalmos, proptosis, lid retraction, periorbital edema, conjunctival injection, chemosis, and diplopia.  Patient reports experiencing foreign body sensation, dryness, gritty sensation, tearing, photophobia, and blurred vision.  On examination, restricted extraocular movements, corneal exposure, and optic nerve compression were noted.  Assessment suggests moderate to severe thyroid eye disease activity and impact on quality of life.  Differential diagnosis includes orbital inflammatory pseudotumor, orbital cellulitis, and other causes of proptosis.  Laboratory evaluation revealed elevated thyroid stimulating hormone receptor antibodies TRAb and elevated free thyroxine T4, confirming hyperthyroidism as the underlying cause.  Current thyroid management includes medication for hyperthyroidism.  Treatment plan for thyroid eye disease includes artificial tears, lubricating ointments, selenium supplementation, smoking cessation counseling, and consideration for corticosteroids, orbital decompression surgery, or teprotumumab if indicated by disease progression.  Patient education provided on the importance of regular follow-up appointments to monitor disease activity and progression, as well as potential complications such as corneal ulceration and optic neuropathy.  ICD-10 code E05.01 for thyrotoxic exophthalmos and relevant CPT codes for ophthalmological examination and procedures will be documented. Medical billing for services rendered will be submitted accordingly.  Follow-up appointment scheduled in four weeks to reassess symptoms, eye involvement, and treatment response.