Role of orbital radiotherapy in thyroid eye disease is controversial

Reviewing recent developments in thyroid eye disease, Cawood and colleagues (p 385) say that numerous retrospective, uncontrolled studies led to the use of radiotherapy, but in recent prospective, placebo controlled trials it led to little or no improvement The authors identify smoking as the most important risk factor for developing thyroid eye disease and list the pitfalls in diagnosis, which include uniocular presentation. They emphasise the need for specialist management by a thyroidologist and an ophthalmologist.