Ophthalmology 423 Thyroid Eye Disease Graves Exophthalmos Proptosis NOSPECS Classification Cause











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NOSPECS Classification 10:20 • REVISION 27:55 • Playlist    • Ophthalmology 08 Eyelid Lacrimal Appa...   • • 1. Lid signs. These are: • • Retraction of the upper lids producing the characteristic staring and frightened appearance (Dalrymple’s sign); is the most common clinical features (90% of cases). • • Lid lag (von Graefe’s sign). i.e., when globe is moved downward, the upper lid lags behind (50% cases). • • Fullness of eyelids due to puffy oedematous swelling (Enroth’s sign); • • Difficulty in eversion of upper lid (Gifford’s sign). • • Infrequent blinking (Stellwag’s sign). • • Ocular motility defects Mobius’s sign • Guanethidine • Orbital decompression Two wall decompression three Four botulinum toxin botox

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