Von Graefe's Sign
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Von Graefe's Sign
Von Graefe's sign is the lagging of the upper eyelid on downward rotation of the human eye, eye, indicating exophthalmos, exophthalmic Goitre, goiter (Graves' disease).Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. 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. It occurs in paramyotonia congenita. 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. See also *Albrecht von Gräfe *Boston's sign *Griffith's sign *Graves orbitopathy *Hyperthyroidism, as lid lag may be in hyperthyroid patients lacking Graves' disease. References

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Eyelid
An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eyelid features a row of eyelashes along the eyelid margin, which serve to heighten the protection of the eye from dust and foreign debris, as well as from perspiration. "Palpebral" (and "blepharal") means relating to the eyelids. Its key function is to regularly spread the tears and other secretions on the eye surface to keep it moist, since the cornea must be continuously moist. They keep the eyes from drying out when asleep. Moreover, the blink reflex protects the eye from foreign bodies. The appearance of the human upper eyelid often varies between different populations. The prevalence of an epicanthic fold covering the inner corner of the eye account for the majority of East Asian and Southeast Asian populations, and is also found i ...
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Human Eye
The human eye is a sensory organ, part of the sensory nervous system, that reacts to visible light and allows humans to use visual information for various purposes including seeing things, keeping balance, and maintaining circadian rhythm. The eye can be considered as a living optical device. It is approximately spherical in shape, with its outer layers, such as the outermost, white part of the eye (the sclera) and one of its inner layers (the pigmented choroid) keeping the eye essentially light tight except on the eye's optic axis. In order, along the optic axis, the optical components consist of a first lens (the cornea—the clear part of the eye) that accomplishes most of the focussing of light from the outside world; then an aperture (the pupil) in a diaphragm (the iris—the coloured part of the eye) that controls the amount of light entering the interior of the eye; then another lens (the crystalline lens) that accomplishes the remaining focussing of light into ...
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Exophthalmos
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 swelling of surrounding tissue resulting from trauma. In the case of Graves' disease, the displacement of the eye results from abnormal connective tissue deposition in the orbit and extraocular muscles, which can be visualized by CT or MRI. If left untreated, exophthalmos can cause the eyelids to fail to close during sleep, leading to corneal dryness and damage. Another possible complication is a form of redness or irritation called superior limbic keratoconjunctivitis, in which the area above the cornea becomes inflamed as a result of increased friction when blinking. The process that is causing the displacement of the eye may also compre ...
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Goitre
A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland. A goitre can be associated with a thyroid that is not functioning properly. Worldwide, over 90% of goitre cases are caused by iodine deficiency. The term is from the Latin ''gutturia'', meaning throat. Most goitres are not cancerous (benign), though they may be potentially harmful. Signs and symptoms A goitre can present as a palpable or visible enlargement of the thyroid gland at the base of the neck. A goitre, if associated with hypothyroidism or hyperthyroidism, may be present with symptoms of the underlying disorder. For hyperthyroidism, the most common symptoms are associated with adrenergic stimulation: tachycardia (increased heart rate), palpitations, nervousness, tremor, increased blood pressure and heat intolerance. Clinical manifestations are often related to hypermetabolism, (increased metabolism), excessive thyroid hormone, an increase in oxygen consumption, metabolic changes in ...
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Graves' Disease
Graves' disease (german: Morbus Basedow), also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid. It frequently results in and is the most common cause of hyperthyroidism. It also often results in an enlarged thyroid. Signs and symptoms of hyperthyroidism may include irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhea and unintentional weight loss. Other symptoms may include thickening of the skin on the shins, known as pretibial myxedema, and eye bulging, a condition caused by Graves' ophthalmopathy. About 25 to 30% of people with the condition develop eye problems. The exact cause of the disease is unclear; however, it is believed to involve a combination of genetic and environmental factors. A person is more likely to be affected if they have a family member with the disease. If one twin is affected, a 30% chance exists that the other twin will also have the disease. The onset of disease may be ...
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Lid Lag
Lid lag is the static situation in which the upper eyelid is higher than normal with the globe in downgaze. It is most often a sign of thyroid eye disease, but may also occur with cicatricial changes to the eyelid or congenital ptosis. Lid lag differs from Von Graefe's sign Von Graefe's sign is the lagging of the upper eyelid on downward rotation of the human eye, eye, indicating exophthalmos, exophthalmic Goitre, goiter (Graves' disease).Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Bu ... in that the latter is a dynamic process. It can also be the manifestation of chemosis (swelling (or edema) of the conjunctiva). References Eye diseases {{Med-sign-stub ...
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Oculomotor Nerve
The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit through the superior orbital fissure and innervates extraocular muscles that enable most movements of the eye and that raise the eyelid. The nerve also contains fibers that innervate the intrinsic eye muscles that enable pupillary constriction and accommodation (ability to focus on near objects as in reading). The oculomotor nerve is derived from the basal plate of the embryonic midbrain. Cranial nerves IV and VI also participate in control of eye movement. Structure The oculomotor nerve originates from the third nerve nucleus at the level of the superior colliculus in the midbrain. The third nerve nucleus is located ventral to the cerebral aqueduct, on the pre-aqueductal grey matter. The fibers from the two third nerve nuclei located laterally on either side of the cerebral aqueduct then pass through the red nucleus. From the red nuc ...
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Paramyotonia Congenita
Paramyotonia congenita (PC) is a rare congenital autosomal dominant neuromuscular disorder characterized by "paradoxical" myotonia. This type of myotonia has been termed paradoxical because it becomes worse with exercise whereas classical myotonia, as seen in myotonia congenita, is alleviated by exercise. PC is also distinguished as it can be induced by cold temperatures. Although more typical of the periodic paralytic disorders, patients with PC may also have potassium-provoked paralysis. PC typically presents within the first decade of life and has 100% penetrance. Patients with this disorder commonly present with myotonia in the face or upper extremities. The lower extremities are generally less affected. While some other related disorders result in muscle atrophy, this is not normally the case with PC. This disease can also present as hyperkalemic periodic paralysis and there is debate as to whether the two disorders are actually distinct. Symptoms and signs Patients typically ...
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Albrecht Von Gräfe
Albrecht von Graefe may refer to: * Albrecht von Graefe (ophthalmologist) (1828-1870), Prussian opthalmologist * Albrecht von Graefe (politician) Albrecht von Graefe (1 January 1868 – 18 April 1933) was a German landowner and right-wing politician active both during the German Empire and the Weimar Republic. Although never a member of the Nazi Party he was an early associate of A ...
(1868-1933), German politician and landowner {{hndis, Graefe, Albrecht von ...
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Boston's Sign
Boston's sign is the spasmodic lowering of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter.Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. 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. As a result, the eyes are often pushed forward in the eye sockets, a condition known as exophthalmos. See also *Graves orbitopathy Graves’ ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (erythema), conjunctivitis, and b ... References Eye diseases Symptoms and signs: Endocrinology, nutrition, and metabolism {{eye-stub ...
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Griffith's Sign
Griffith's sign is a clinical sign in which there is lid lag of the lower eyelid on moving the eye upwards. It is found in Graves' ophthalmopathy. See also * Von Graefe's sign Von Graefe's sign is the lagging of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter (Graves' disease).Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 199 ... * Boston's sign References Symptoms and signs: Endocrinology, nutrition, and metabolism Endocrinology Medical signs {{eye-stub ...
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Graves Orbitopathy
Graves’ ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (erythema), conjunctivitis, and bulging eyes (exophthalmos). It occurs most commonly in individuals with Graves' disease, and less commonly in individuals with Hashimoto's thyroiditis, or in those who are euthyroid. It is part of a systemic process with variable expression in the eyes, thyroid, and skin, caused by autoantibodies that bind to tissues in those organs. The autoantibodies target the fibroblasts in the eye muscles, and those fibroblasts can differentiate into fat cells (adipocytes). Fat cells and muscles expand and become inflamed. Veins become compressed and are unable to drain fluid, causing edema. Annual incidence is 16/100,000 in women, 3/100,000 in men. About 3–5% have severe disease with intense pain, and sight-threatening corneal ulceration or compre ...
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