Which sign is described as globe lag when looking up?

• A. Von Graefe's sign
• B. Dalrymple's sign
• C. Kocher's sign
• D. Stellwag's sign

Answer: (C)

Kocher's sign describes globe lag when looking upward. This occurs in Graves' orbitopathy where inflammation and fibrosis often affect the inferior rectus, making upward movement of the eye restricted. When the patient attempts to look up, the eyelids can move more readily (and lid retraction may be present), while the globe lags behind due to the restricted extraocular muscle. This lag is a telltale sign of restrictive eye movement from orbital disease. Other signs in Graves' disease relate to lid position or blinking (lid retraction with scleral show, or infrequent blinking), not this specific globe lag in upgaze.