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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Graefe, Friedrich Wilhelm Ernst Albrecht von (1828–1870) Eye surgeon from Berlin who introduced modern surgical ophthalmology. He founded Archiv für Ophthalmologie in 1854 and introduced iridectomy in 1855 in treatment of glaucoma and iritis, and as part of the cataract operation. He performed an operation for strabismus in 1857 and introduced the linear method of cataract extraction in 1868. He described the stationary nature of the eyelid or lid lag sign of the eye in thyrotoxicosis, known as ‘von Graefe sign’. He designed operations for squint, glaucoma, cataract, conical cornea and other eye conditions.
Specific Synonyms
Published in Terence R. Anthoney, Neuroanatomy and the Neurologic Exam, 2017
Graefe’s sign (DeJ, p. 136) Lid lag (ibid.)Von Graefe’s sign (Bann, p. 49)Although some authors describe lid lag as equivalent to (von) Graefe’s sign, the latter is usually associated only with hyperthyroidism (e.g., DeJ, p. 136; Hensyl, 1982, p. 1287; Friel, 1981, p. 1202). Lid lag, however, has also been described in myotonic states-"in myotonic lid lag the upper lids remain retracted briefly and then descend slowly on looking downward immediately after a period of upward gaze” (Del, p. 138).
Gaze-Evoked Vision Changes
Published in Journal of Binocular Vision and Ocular Motility, 2023
Isdin Oke, Steven D. Ness, Crandall E. Peeler
In this case, adduction of the right eye resulted in simultaneous pupil constriction and a myopic shift of approximately 2.5 diopters. These findings suggest abnormal communication between axons destined for the medial rectus (adductor) and those destined for muscles involved in the accommodative response: the pupillary sphincter (miosis) and ciliary muscle (myopic shift). There have been several reports of this pupillary response (Czarnecki sign),1–3 but, to our knowledge, no cases that document the change in refraction from ciliary muscle involvement. Other classic signs of oculomotor synkinesis include elevation of the eyelid on downgaze or adduction (pseudo-von Graefe sign) or globe retraction on attempted elevation or depression.4 Aberrant regeneration may occur in the setting of trauma or compression of the 3rd cranial nerve5,6 and additional work-up may be indicated if the underlying etiology is unknown.
Thyroid-Associated Orbitopathy: Management and Treatment
Published in Journal of Binocular Vision and Ocular Motility, 2022
Lauren Hennein, Shira L. Robbins
The ophthalmic symptoms of TAO include dry eyes, injected eyes, blurry vision, binocular diplopia (especially in the extremes of gaze), and pain with extraocular movement.13 The ophthalmic clinical manifestations of TAO include exophthalmos, eyelid retraction (particularly lateral retraction), lid lag on downgaze (i.e. von Graefe’s sign), conjunctival injection and chemosis, orbital fat prolapse, exposure keratopathy, periorbital edema, restrictive myopathy, and optic neuropathy.15 The inferior rectus muscle is classically affected first, followed by the medial rectus, superior rectus, and then lateral rectus muscle. The oblique muscles are involved less frequently and can rarely cause cyclotorsional deviations.16 TAO can be classified as Type I which is predominantly fat compartment enlargement, or Type 2 which is predominantly extraocular muscle enlargement.17
Functional TSH receptor antibodies in children with autoimmune thyroid diseases
Published in Autoimmunity, 2018
Karolina Stożek, Artur Bossowski, Katarzyna Ziora, Anna Bossowska, Małgorzata Mrugacz, Anna Noczyńska, Mieczysław Walczak, Elżbieta Petriczko, Beata Pyrżak, Anna Kucharska, Mieczysław Szalecki, Tanja Diana, George J. Kahaly
The diagnosis of GD + TAO consists of three elements: the presence of eye signs and symptoms, attendance of AITD and eventually performing differential diagnostics. Possible clinical symptoms include eyelid swelling, and retraction, proptosis, restriction of the upper eyelid, positive Von Graefe’s sign, positive Kocher’s and Stellwag’s sign, swelling, decreased visual acuity. Redness of the lids and conjunctiva, chemosis and caruncula swelling are typical of the active state of GD + TAO. Clinical presentation of GD + TAO in childhood is less severe than in adulthood. Predominant eye changes include soft-tissue involvement and proptosis [17,18]. Ophthalmic examination in GD + TAO cases involves visual acuity assessment, intraocular pressure measurement, exophthalmos measurement (using a Hertel exophthalmometer), eyeball motility, diplopia and soft tissue (eyelids, conjunctivas) assessment, clarity of cornea and lens examination, and eye fundus investigation [18].