Oldies, but goodies…
Posted by : Debby Jass on 02/21/98 at 19:23:06
From the NGDF’s Bulletin #7, “Thyroid Eye Disease – Double Vision
and Loss of Vision” by Robert H. Spector, M.D.:
“Lid retraction gives the hyperthyroid patient their ‘bug-eyed’
appearance. The eyes seem prominent either because they are pushed
outward, a term referred to as proptosis or exophthalmos, or because
the upper lids are abnormally pulled back and the white portion of
the eye (sclera) shows more than usual. Normally, the upper lid just
touches the upper border of the iris and the lower lid just covers
the lower iris margin, so there is no ‘scleral show’ between the top
and bottom of the iris and the surrounding sclera. When scleral
show is present with the eyes looking straight ahead, there is lid
retraction, and when it occurs as the patient slowly moves their
eyes downward, it is called LID LAG. Lid retraction and lid lag may
occur in one or both eyes; it can be asymmetric, intermittent, and
sometimes quite subtle. Although lid lag and lid retraction occur
most commonly in patients with thyroid eye disease, it can also be
seen in a number of other neuro-ophthalmic disorders.”
Posted by : Denise D. on 02/21/98 at 19:28:32
According to the “Manual of Ocular Diagnosis and Therapy,” LID LAG is as follows under the thyroid section-
Key clinical signs and their eponyms:
1.Lid retraction
2.Upper lid “lag” on downward gaze
3.Upper lid resistance to downward retraction
4.Tremor of closed lids
5 Infrequent blink
6.Increased lid pigmentation
7.Poor convergence
8.Extraocular muscle palsies
