The observation in this study of 33 pediatric patients with thyroid disfunction supports the view that ocular changes are uncommon in this age group. If ophthalmopathy does occur, it is mild. No patient was found to have clinical myopathy, corneal involvement, or visual loss. B Scan Ultrasonography demonstrated extraocular muscle involvement despite the absence of clinical signs and symptoms of myopathy. There was no HLA antigen prevalence in those patients with ophthalmopathy as compared with those free of ocular change. It is suggested that the conservative medical management of the pediatric group with thyroid disease may account for the low incidence of severe ocular changes.