Thyroid eye disease (TED) is a complex, organ-specific autoimmune disorder closely related to thyroid diseases and one of the common orbital diseases in adults. The disease follows a characteristic “biphasic” course (active and inactive phases), with a broad spectrum of clinical manifestations ranging from mild eyelid retraction and lag to vision-threatening optic neuropathy and severe exposure keratopathy, imposing a significant physical and psychological burden on patients' quality of life as well as their physical and mental health. In current neuro-ophthalmology practice, the lack of a standardized and uniform assessment protocol leads to considerable variability in TED management strategies across different regions and clinicians. Furthermore, the complex nature of TED necessitates management beyond the scope of a single specialty, highlighting an urgent need for multidisciplinary collaboration. This consensus aims to establish and promote a standardized TED assessment system led by neuro-ophthalmologists. It emphasizes standardization, precision, and clinical operability, while advocating for a routine, institutionalized, and patient-centered multidisciplinary model to optimize clinical decisions and ultimately improve patient outcomes.
Myasthenia gravis (MG) is an autoimmune disease characterized by autoantibody-mediated acquired neuromuscular junction transmission disorders. Based on the different muscles involved, approximately 80% MG can be classified into ocular MG (OMG) and generalized MG. Eighty percent of MG patients initially present with OMG, leading to ptosis and diplopia, which significantly impair their quality of life. Approximately 50.0% to 69.7% of OMG patients may progress to generalized MG within two years, exhibiting symptoms such as limb weakness, dysphagia, and even respiratory failure that threatens life. Due to the diverse manifestations and fluctuating symptoms of OMG, it is often prone to missed and/or misdiagnosis. To further standardize the understanding of OMG among clinicians, Neuro-Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association, Neuro-Ophthalmology Society of Chinese Research Hospital Association, in conjunction with relevant domestic and international researches, consensuses, guidelines and based on the actual situation in China, have developed the Chinese expert consensus on the clinical diagnosis and management of ocular myasthenia gravis (2025). The consensus comprehensively covers clinical diagnosis and management of OMG, including epidemiology, mechanisms of ocular extraocular muscle involvement in MG, clinical manifestations, auxiliary examinations, diagnosis, differential diagnosis, treatment, assessment and prevention strategies for generalized transformation of OMG, and diagnosis and management of refractory OMG, with detailed recommendations provided in nine sections. This consensus is applicable to ophthalmologists, neuro-ophthalmologists, neurologists, and medical personnel engaged in the diagnosis and management of OMG. It aims to standardize the diagnosis and management process of OMG, improve early identification and treatment capabilities, alleviate ocular symptoms of OMG and reduce the risk of generalized transformation.
