Von Graefe's sign


Von Graefe's sign is the lagging of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter. It is a dynamic sign, whereas lid lag is a static sign which may also be present in cicatricial eyelid retraction or congenital ptosis.
A pseudo Graefe's sign shows a similar lag, but is due to aberrant regeneration of fibres of the oculomotor nerve into the elevator of the upper lid. It occurs in paramyotonia congenita.
A pseudo Graefe's sign is most commonly manifested in just one eye but can occasionally be observed in both. The reason only one eye is affected is not yet clear.