004-3 Lid Lag
Identifier: 004-3 Title: Lid Lag Subject: Lid Lag; Bilateral Exophthalmos; Restrictive Orbitopathy of Graves' Disease; Description: The classical eye signs of thyroid associated ophthalmopathy (TAO) of Graves' Disease is illustrated by case ID925-4. This 50 year old woman with TAO is included in the collection because she illustrates very well lid lag (persistent elevation of the upper eyelid in downgaze) – von Graefe sign. Eyelid position is coordinated with vertical eye movements. In upgaze the lids elevate. In downgaze the lids typically relax and follow the globe down and close. In TAO, in addition to patients with dorsal midbrain lesions (ID 921-1, 924-2 and 925-4) the normal relationship is impaired and the eyelids remain elevated while the eyes move down.