Grave’s disease is a clinical syndrome consisting of hypermetabolism, diffuse thyroid enlargement and exophthalmos. Which has ocular complications. Due to the high incidence of these complications and the risk of blindness special attention is needed. Many therapeutic methods including medical surgical and radiotherapy for ocular complications are suggested. In cases of medical therapy failure, surgery is recommended. One of its methods is orbital decompression and if needed optic nerve decompression by transnasal endoscopy. A Graves’ patient with bilateral exophthalmos and severe visual loss was operated. With this method. After surgery in addition to return of normal eye appearance and eye movements, visual acuity of left eye improved significantly. This article describes this method, its results and complications