Von Graefe’s sign (lid lag sign) is the immobility or lagging of the upper eyelid on downward rotation of the eye, indicating exophthalmic goiter (Graves’ Disease).
A pseudo Graefe’s sign (pseudo lid lag) shows a similar lag, but is due to aberrant regeneration of fibres of the oculomotor nerve (III) 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 why only one eye is affected is not yet clear.
Von Garefe’s sign: In this video the upper eyelid does not accompany the eyeball in the downward
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