Eponymous Signs of Thyroid Ophthalmopathy

Eponymous Signs of Thyroid Ophthalmopathy:

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Lid Signs of Thyroid Ophthalmopathy:

1. Dalrymple’s Sign: Lid Retraction.
2. Von Graefe’s Sign: Lid lag of the upper eyelid on downward gaze.
3. Vigoroux Sign: Eyelid fullness/swelling. (Figure 1)
4. Grove Sign: Resistance to pulling down the retracted upper lid.
5. Rosenbach’s Sign: Fine tremors of the eyelids when closed.
6. Gifford’s Sign: Difficulty in everting upper lid.
7. Enroth Sign: Edema of lower lid. (Figure 1)
8. Boston’s Sign: jerky irregular movement of upper lid on downward gaze.
9. Kocher’s Sign: Increased lid retraction with visual f ixation (staring look). (Figure 2)
10. Abadie Sign: Spasm of the levator palpebrae superioris muscle with retraction of the upper lid.
11. Riesman’s sign: Bruit heard over the closed eye with a stethoscope.

Facial Signs of Thyroid Ophthalmopathy::

1. Stellwag Sign: Incomplete and infrequent blinking (staring look).
2. Joffroy Sign: Absent creases in the forehead on superior gaze. (Figure 3)
3. Jellinek’s Sign: Hyperpigmentation of the superior eye folds.
4. Hertoge’s Sign: Loss of the lateral third of eyebrows.
5. Sainton’s sign: Delayed forehead wrinkling on up gaze.

Extra-Ocular Muscle Signs:

1. Möbius Sign: Inability to converge. (Figure 4)
2. Ballet Sign: Restriction of one or more extraocular muscles.
3. Jendrassik’s Sign: Limitation of abduction and rotation of eyeballs.
4. Suker’s Sign: Poor fixation on abduction.

Pupillary Signs:

1. Cowen’s Sign: Jerky pupillary constriction to light.
2. Lowy’s Sign: Mydriasis with instillation of lower concentration of adrenaline.
3. Knies’s sign: Unequal dilatation of pupil in dim light.

Others:

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

Credit: Singh P. Eponymous Signs of Thyroid Ophthalmopathy.