AIM: To report a case series of patients who had manifestation or aggravation of thyroid related orbitopathy (TRO) following cataract surgery in an Asian eye centre. METHODS: A systematic review of clinical records of patients with manifestation or aggravation of TRO was conducted. Inclusion criteria were manifestation or aggravation of TRO within 6 months of cataract surgery. RESULTS: Five patients treated for TRO at Singapore National Eye Centre from January 2007 to December 2008 were included in the study. There were 2 males and 3 females with mean age of 54.6 years (range 51-86). Surgery included phacoemulsification with implantation of intraocular lens. The mean interval between surgery and manifestation of symptoms was 7.4 weeks. Contralateral eye involvement was seen in all patients. Clinical presentation of orbitopathy ranged from increased soft issue swelling, proptosis and progression of myopathy to compressive optic neuropathy. One patient had total loss of vision. Mean follow-up was 21 months (range 2-60). CONCLUSION: TRO can present shortly after cataract surgery and lead to serious vision threatening complications. Patients will need to be counseled pre-operatively regarding the risk of post-operative period.