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Eponymous Signs of Thyroid Ophthalmopathy

Article in Delhi Journal of Ophthalmology · July 2019

DOI: 10.7869/djo.493

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DJO Vol. 30, No. 1, July-September 2019

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Eponymous Signs of Thyroid Ophthalmopathy

Pallavi Singh
Dr. R.P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India

Delhi J Ophthalmol 2019;29;87-88; Doi http://dx.doi.org/10.7869/djo.493

Lid Signs
• Dalrymple’s Sign: Lid Retraction.
• Von Graefe’s Sign: Lid lag of the upper eyelid on
downward gaze.
• Vigoroux Sign: Eyelid fullness/swelling. (Figure 1)
• Grove Sign: Resistance to pulling down the retracted
upper lid.
• Rosenbach's Sign: Fine tremors of the eyelids when
closed.
• Gifford’s Sign: Difficulty in everting upper lid. Figure 1
• Enroth Sign: Edema of lower lid. (Figure 1)
• Boston’s Sign: jerky irregular movement of upper lid on
downward gaze.
• Kocher’s Sign: Increased lid retraction with visual
fixation (staring look). (Figure 2)
• Abadie Sign: Spasm of the levator palpebrae superioris
muscle with retraction of the upper lid.
• Riesman's sign: Bruit heard over the closed eye with a
stethoscope.
Figure 2
Facial Signs
• Stellwag Sign: Incomplete and infrequent blinking
(staring look).
• Joffroy Sign: Absent creases in the forehead on superior
gaze. (Figure 3)
• Jellinek's Sign: Hyperpigmentation of the superior eye
folds.
• Hertoge’s Sign: Loss of the lateral third of eyebrows.
• Sainton’s sign: Delayed forehead wrinkling on up gaze.
Figure 3
Extra-Ocular Muscle Signs
• Möbius Sign: Inability to converge. (Figure 4)
• Ballet Sign: Restriction of one or more extraocular
muscles.
• Jendrassik's Sign: Limitation of abduction and rotation
of eyeballs.
• Suker’s Sign: Poor fixation on abduction.

Pupillary Signs
• Cowen’s Sign: Jerky pupillary constriction to light. Figure 4
• Lowy’s Sign: Mydriasis with instillation of lower
concentration of adrenaline.
• Knies’s sign: Unequal dilatation of pupil in dim light.

Others
• Goldzeiher’s Sign: Deep injection of the bulbar
conjunctiva. (Figure 5)
• Payne Trouseau Sign: Globe luxation.
• Sattler Sign: Increased intra-ocular pressure in upgaze.
Figure 5

E-ISSN: 2454-2784 P-ISSN: 0972-0200 87 Delhi Journal of Ophthalmology

DJO Vol. 30, No. 1, July-September 2019

Cite This Article as: Singh P. Eponymous Signs of Thyroid

Ophthalmopathy.

Acknowledgments: Nil

Conflict of interest: None declared

Source of Funding: None

Date of Submission: 9 October 2019

Date of Acceptance: 21 October 2019

Address for correspondence

Pallavi Singh MD, FICO
Dr. R.P. Centre for Ophthalmic Sciences,
AIIMS New Delhi, India
Email: drpallavisingh.rpc@gmail.com

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E-ISSN: 2454-2784 P-ISSN: 0972-0200 88 www.djo.org.in

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