Question
This patient is suffering from thyrotoxicosis.When she looks up,following picture is seen.Identify this sign.

A. Von Graefe’s sign
B. Joffroy’s sign
C. Moebius sign
D. Dalrymple’s sign
Show Answer
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Correct Answer » B Explanation |
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Ans:B. Joffroy’s sign
Eye signs in thyrotoxicosis
- Stellwag’s sign: staring look, absent of normal blinking, first sign to appear(mild hyperthyroidism)
- Von Graefe’s sign(Lid Lag sign): inability of upper eyelid to keep pace with the eyeball (mild)
- Joffroy’s sign: absence of wrinkling on forehead when the patient looks up(frowns)(moderate)
- Moebius sign: lack of convergence of eyeball(severe hyperthyroidism)
- Dalrymple’s sign: upper eyelid retraction, sclera visible
- Jellinek’s sign: increased pigmentation of eyelid margins
- Enroth sign: edema of eyelids and conjunctiva
- Rosenbach’s sign: tremor of closed eyelids
- Gifford’s sign: difficulty in everting upper eyelid in primary toxic thyroid. Differentiates exophthalmos from other causes
- Loewi’s sign: dilation of pupil with weak adrenaline solution
- Knie’s sign: unequal dilation of pupil
- Cowen’s sign: jerky papillary contraction to consensual light
- Kocher’s sign: when clinician places his hands on patient’s eyes and lifts it higher, patient’s upper eyelid springs up more quickly than eye brows
- Naffziger’s sign: with patient in sitting position and neck fully extended, protruded eyeball can be visualized when observed from behind
- Proptosis due to infiltration of retrobulbar tissues with fluid and round cells
- Weakness of extraocular muscles(particularly inferior oblique) results in diplopia
- The most common ocular motility defect is a unilateral elevator palsy caused by the involvement of inferior rectus; next common – failure of abduction due to involvement of medial rectus


