Around one third of children with thyrotoxicosis will have significant eye disease. This ranges from minimal lid lag through proptosis to ophthalmoplegia. It is recommended that an opthalmological opinion be sought soon after the diagnosis in these cases. Some children may develop eye signs after diagnosis and treatment has been established.

There is a well established link between severity of eye disease and active smoking. Children who smoke
should be informed of this14 ,15.

Steroid prophylaxis is required prior to RI therapy, if there are concerns about eye disease( Kahaly et al).