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Convergence-retraction nystagmus: Attempts at upward gaze often produce this phenomenon. On fast up-gaze, the eyes pull in and the globes retract. The easiest way to bring out this reaction is to ask the patient to follow down-going stripes on an optokinetic drum. [9] Eyelid retraction (Collier's sign)
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 ...
Photo showing the classic finding of proptosis and lid retraction in Graves' disease. Graves' ophthalmopathy is characterized by inflammation of the extraocular muscles, orbital fat and connective tissue. It results in the following signs, which can be extremely distressing to the patient: [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.
Class 1: Only signs (limited to upper lid retraction and stare, with or without lid lag) Class 2: Soft tissue involvement (oedema of conjunctivae and lids, conjunctival injection, etc.) Class 3: Proptosis; Class 4: Extraocular muscle involvement (usually with diplopia) Class 5: Corneal involvement (primarily due to lagophthalmos)
Collier's sign (also known as Collier's tucked lid sign [1] or posterior fossa stare [2]) is bilateral or unilateral eyelid retraction. It is an accepted medical sign of a midbrain lesion, first described in 1927 by J Collier. [ 3 ]
(1) finger held in slight flexion, (2) fusiform swelling, (3) tenderness along the flexor tendon sheath, and (4) pain with passive extension of the digit. Kayser–Fleischer ring: Bernhard Kayser, Bruno Fleischer: neurology, gastroenterology: Wilson's disease (hepatolenticular degeneration) ring of brownish copper deposit at corneo-scleral junction
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).