Lower lid retraction: A valuable finding in juvenile Graves' orbitopathy

Purpose: To evaluate the findings of juvenile Graves' orbitopathy. Subjects and Methods: Retrospective evaluation of our patients with Graves' disease who are younger than 16 years. Results: Seventeen patients younger than 16 years were identified among 138 patients who were being treated for hyperthyroidism and goiter. Eleven (64.7%) of them had lid findings, orbital findings, or both and constituted 8.8% of the total of 125 such patients. Ophthalmic signs were common and were among the presenting signs in children with Graves' disease. Orbitopathy was mild and was more frequent in girls. Lower lid retraction and lag (ie, hesitation of the lower lids to follow upgaze) appeared to be constant and early findings. Conclusion: Ophthalmologists and pediatricians should be aware of and look for lid signs in children presenting with related complaints and a history suggesting hyperthyroidism, goiter, or both.