have a later onset and a poor prognosis. a study demonstrated that at the time of diagnosis, 90% of the patients with clinical orbitopathy were hyperthyroid according to thyroid function tests, while 3% had hashimoto's thyroiditis, 1% were hypothyroid and 6% did not have any thyroid function tests abnormality. of patients with graves' hyperthyroidism, 20 to 25 percent have clinically obvious graves' ophthalmopathy, while only 3–5% will develop severe ophthalmopathy. history in medical literature, robert james graves, in 1835, was the first to describe the association of a thyroid goitre with exophthalmos (proptosis) of the eye. graves' ophthalmopathy may occur before, with, or after the onset of overt thyroid disease and usually has a slow onset over many months.