Lid Lag Sign

This is a sign in thyrotoxicosis

Category:

Science & Technology

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• thyrotoxicosis

[shaqkillz451]

@shaqkillz451

Therefore, the reason you can see more of the white of the right eye is NOT because the right eyelid is more elevated the left, it is b/c the right eye is more protruding than the left.

The lid lag sign is the inability of the eyelid to follow movement of the eyeball downward quickly enough, hence you can see the upper sclera (white of the eye) of the eye. The lid lag sign will be more obvious in an eye which is already more protruding, as in the right eye in this patient.

[shaqkillz451]

Normally in hyperthyroidism due to Graves disesase, you can have unilateral proptosis, meaning one eyeball protrudes slightly more than the other. In this setting, the person's right eye is more protruding than the left, which is probably the reason why the right eye lid seems more elevated. In Graves, the eyelids are usually more elevated but this is usually equal and bilateral (it occurs due to hyperactivity of the levator palpebrae muscle of the eyelid). (SEE my other comment below)

[tomcat624u]

1 OF HER EYES LOOKS LIKE THAT OF A PERSON WITH GRAVES DISEASE.

[TheRedFuji]

I'm having trouble seeing the lid lag in this video... I looks to me that the patient's eyelids respond pretty quickly when her gaze changes directions. This is definitely so in the second half of the video when she gazes downward. There's exophthalmos in her right eye so some sclera always shows between her upper lid margin and cornea, but this is present independent of movement and does not fit the definition of lid lag.

[MrSimba44]

I have graves and I suddenly developed lid lag, my skin is so lovely and I looked really stunning 6 months ago but due to graves I look like a frog. Just fallen apart

[MrsMilenaRubio]

i've got that as well. mine is caused by hashitoxicosis (graves AND hashimoto)

[hazemalsaadi]

@melissagraves79 many possible causes. if it is unilateral, it could be exophthalmos due to a tumor

[agrigento09]

@melissagraves79 that could be a serious neurological problem. It doesn't sound like a thyroid problem. I would go to a family physician to have a quick neurological screening exam, and perhaps push for a neurologist referral.

[melissagraves79]

my right eye is buldging out of my head... i hate it , it has caused double vision and it makes me sick to my stomach.... not to mention i at one time was very social now all i want to do is hide HELP

[strongboy2005]

In the patient's right eye, you can appreciate that when the patient looks down the sclera is visible between the upper eye lid and the corneoscleral junction. This is the lid lag sign.