Thyroid-related ophthalmopathy is the most common orbital disease in adulthood. It is an autoimmune disease with diverse and complex clinical manifestations and is easily confused with various ophthalmic diseases. In order to improve the diagnosis of thyroid-related ophthalmology, this article lists a variety of ophthalmic diseases that need to be differentiated according to the characteristics of clinical manifestations, and introduces the main differentiation methods and principles of diagnosis and treatment, providing reference for ophthalmologists and endocrinologists. (Chin J Ophthalmol, 2021, 57: 809-813).