Von Graefe's sign

Von Graefe's sign
Differential diagnosisexophthalmic goiter

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.

A pseudo Graefe's sign (pseudo lid lag) shows a similar lag, but is due to aberrant regeneration of fibres of the oculomotor nerve (III) into the elevator of the upper lid.[2] It occurs in paramyotonia congenita.[3] A pseudo Graefe's sign is most commonly manifested in just one eye but can occasionally be observed in both. The reason only one eye is affected is not yet clear.

  1. ^ Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0
  2. ^ Definition: pseudo-Graefe sign from Online Medical Dictionary
  3. ^ Fowler, Timothy J.; John W. Scadding (2003). Clinical Neurology 3rd ed. p. 145. ISBN 0-340-80798-9.
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