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  1. Creig Hoyt, Editor

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    HOW DO WE KNOW WHAT TO DO?

    This issue of the BJO highlights several aspects of the dilemma ophthalmologists face when dealing with a specific clinical problem. What data are they to use in making their therapeutic decisions? Clearly in the past decade the randomised multicentred prospective trial has become the gold standard for assessing therapeutic options in medicine. Regrettably, only a minority of the clinical problems that face ophthalmologists on a daily basis have been submitted to this rigorous format. As a result, therefore, many important questions are still answered by less adequate means: retrospective and poorly controlled studies and even less satisfactorily depending on expert opinions. Far too often one still hears “in my experience” used to justify major medical decisions. See 51

    THE PATIENT WITH THYROID DISEASE

    Susan Lightman and Peter McCluskey have organised a provocative series of controversies in ophthalmology. In this month's issue they dramatically demonstrate that even in the most common ophthalmic disorders there can still be considerable debate about what is the appropriate therapy. In a case of thyroid orbitopathy some things are clear. Lid surgery, strabismus surgery, treatment of dry eye, and re-establishment of a normal thyroid status are all fundamental keystones to the therapeutic programme in these patients. …

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