**1. Introduction**

Graves' Disease (GD) is the commonest cause of hyperthyroidism world over representing more than 50% of hyperthyroid patients [1]. A woman is 7–10 times more likely to be affected by it [2]. The incidence of autoimmune thyroid diseases like GD and Hashimoto's thyroiditis is on the rise in tropical countries probably due to environmental immunological factors [3]. GD has systemic manifestations. Eyes's are involved to variable extent in more than half the patients. Treatment aims to restore to the thyroid hormones to normal levels along with achieving remission and care of ophthalmological manifestations. Anti-thyroid drugs (ATD), Radioactive Iodine (RAI) and surgery are the current modalities of treatment [1]. They have their unique indications, advantages, disadvantages and complications. ATD are the usual first line of treatment. Relapsing patients or GD with certain co existing conditions may require a definitive treatment. RAI or surgery are indicated in such patients. The choice of definitive therapy depends on the patient and treating physician. Patients involvement in decision making has been associated with increased patients satisfaction [4, 5].
