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Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen in an orbital tumor). Complete or partial dislocation from the orbit is also possible from trauma or ...
Abadie's sign of exophthalmic goiter is a medical sign characterized by spasm of the levator palpebrae superioris muscle with retraction of the upper lid (so that sclera is visible above cornea) seen in Graves-Basedow disease which, together with exophthalmos causes the bulging eyes appearance. [1] It is named for Jean Marie Charles Abadie. [2] [3]
In mild disease, patients present with eyelid retraction. In fact, upper eyelid retraction is the most common ocular sign of Graves' orbitopathy. This finding is associated with lid lag on infraduction (Von Graefe's sign), eye globe lag on supraduction (Kocher's sign), a widened palpebral fissure during fixation (Dalrymple's sign) and an incapacity of closing the eyelids completely ...
It results in the following signs, which can be extremely distressing to the patient: [4] Most frequent are symptoms due to conjunctival or corneal irritation: burning, photophobia, tearing, pain, and a gritty or sandy sensation. [4] Protruding eyeballs (known as proptosis and exophthalmos). Diplopia (double vision) is common. [4]
Von Graefe's sign is the lagging of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter (Graves' disease). [1] It is a dynamic sign, whereas lid lag is a static sign which may also be present in cicatricial eyelid retraction or congenital ptosis.
Boston's sign is the spasmodic lowering of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter. [1] Similar to von Graefe's sign, it is observed in people with Graves-Basedow disease, a type of hyperthyroidism. In this disease, the immune system attacks the thyroid gland and the soft tissues surrounding the eyes.
Two signs are truly diagnostic of Graves' disease (i.e., not seen in other hyperthyroid conditions): exophthalmos and non-pitting edema (pretibial myxedema). Goiter is an enlarged thyroid gland and is of the diffuse type (i.e., spread throughout the gland).
Joffroy's sign is a clinical sign in which there is a lack of wrinkling of the forehead when a patient looks up with the head bent forwards. [1] It occurs in patients with exophthalmos in Graves disease .