Purpose: To describe the clinical features and prognosis of pediatric Graves’ orbitopathy in Korea and investigate the factors that are related to disease activity.

Methods: This is a retrospective study of 19 patients who were referred to our clinic and diagnosed with pediatric Graves’ orbitopathy from March 2005 to August 2012. All patients were re-evaluated for at least 6 months and analyzed by Clinical Activity Score (CAS) and NOSPECS classifications.

Results: Most patients had mild findings consistent with Graves’ orbitopathy. Proptosis was noted in 12 of 19 patients (63.2%). Lid retraction was present in 7 of 19 patients (36.8%). Extraocular muscle involvement was identified in only 1 of 19 patients (5.3%). No patients had corneal problem or optic neuropathy. Only conservative ophthalmic management was needed in most patients and aggressive treatment like orbital radiation therapy or surgery was never indicated.

Conclusions: The clinical manifestations of Graves’ orbitopathy are relatively less severe in pediatric patients than in adults in whom prominent proptosis appears and Graves’ orbitopathy–associated optic neuropathy is not rarely encountered. Most pediatric patients show mild ophthalmic symptoms and signs which easily resolve with conservative therapy.