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.


  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.

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