Graves’ Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management

Figure 4

Threatening-to-vision GO. (a) Initial presentation of a patient with threatening-to-vision GO. LE: corneal breakdown, chemosis, conjunctival redness, eyelid swelling, swollen caruncle, retrobulbar ache at rest and with gaze, diurnal variation (inflammatory score: 9/10), proptosis > 2 mm, optic neuropathy, and extraocular muscle restriction (3/3 progression score). (b) Appearance after methylprednosolone IV treatment, amniotic membrane transplant, and lateral tarsorrhaphy in LE. (c) Appearance after bilateral orbital decompression and levator recession surgery (Dr. Barrio-Barrio and Dr. Fernandez-Hermida performed the surgical procedures).

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