Thyroid

Graves Orbitopathy
1. Vigouroux sign (eyelid fullness)
2. Stellwag sign (incomplete and infrequent
blinking)
3. Grove sign (resistance to pulling down the
retracted upper lid)
4. Joffroy sign (absent creases in the
forehead on superior gaze)
5. Mbius sign (poor convergence)
6. Ballet sign (restriction of one or more
extraocular muscles)
1. Edsel Ing, MD, FRCSC. Thyroid-Associated Orbitopathy. http://
emedicine.medscape.com
2. Yash Shah. Thyroid Ophthalmopathy - Special Issue on Indian Thyroid

 1.Abadie's sign Elevator muscle of upper eyelid is

spastic.
2. Beck's sign Abnormal intense pulsation of
retina's arteries
3. Boston's sign Jerky movements of upper lid on
lower gaze
4. Coweh's sign Extensive hippus of consensual
pupillary reflex
5. Darlimple's sign Upper lid retraction
6. Enroth's sign Oedema of the lower lid
7. Gifford's sign Difficulty in eversion of upper lid.

 8. Goldziehers sign Deep injection of conjunctiva,

especially temporal
9. Griffiths sign Lower lid lag on upward gaze
10. Hertoge's sign Loss of eyebrows laterally
11. Jellinek's sign Superior eyelid folds is
hyperpigmented
12. Jendrassik's sign Abduction and rotation of eyeball
is limited also
13. Knies sign Uneven pupillary dilatation in dim light
14. Kocher's sign Spasmatic retraction of upper lid on
fixation

 15. Loewi's sign Quick Mydriasis after instillation of

1:1000 adrenaline
16. Mann's sign Eyes seem to be situated at different
levels because of tanned skin.
17. Means Increased scleral show on upgaze(globe lag)
18. Moebius's sign Lack of convergence
19. Payne-Trousseau Dislocation of globe
20. Pochin Reduced amplitude of blinking
21. Riesmans Bruit over the eyelid
22. Movement's cap phenomenon Eyeball movements
are performed difficultly, abruptly and incompletely

 23. Rosenbach's sign Eyelids are animated by thin tremors when

closed
24. Saiton's sign Frontalis contraction after cessation of levator
activity
25. Snellen-Rieseman's sign When placing the stethoscope's
capsule over closed eyelids a systolic murmur could be heard
26. Suker's sign Inability to maintain fixation on extreme lateral
gaze
27. Tellas's sign Inferior eyelid might be hyperpigmented
28. Topolanski's sign Around insertion areas of the four rectus
muscles of the eyeball a vascular band network is noticed and this
network joints the four insertion points.
29. von Graefe's sign Upper lid lag on down gaze
30. Wilder's sign Jerking of the eye on movement from abduction to
adduction

NOSPECS classification for

remembering clinical
features
N - No signs or symptoms
O - Only signs (such as
lid retraction), no
symptoms
S - Soft tissue
involvement
P - Proptosis
E - Extraocular muscle
C - Corneal involvement
S - Sight loss