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How to elicit Von Graefe's sign:an OSCE guide

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Von Graefes sign is an important eye sign in hyperthyroidism.It is elicited as follows
  • The patient looks straight ahead.
  • Ask the patient to look down.
  • Look for a lag of the upper eyelid.
It is the lagging of the upper eyelid on downward rotation of the eye and indicate  underlying  Graves' Disease
The terms lid lag and von Graefe's sign have been used interchangeably in the past; but, they are distinct signs of downgaze-related upper eyelid static position and dynamic movement, respectively.