Journal of Ophthalmology / 2015 / Article / Tab 1

Review Article

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

Table 1

NO SPECS modified classification [22].

ClassGradeSuggestions for grading

0No physical signs or symptoms

IOnly signs

IISoft tissue involvement

IIIProptosis (3 mm or more of normal upper limits with or without symptoms)
a3 or 4 mm over upper normal
b5 to 7 mm increase
c8 mm increase

IVExtraocular muscle involvement (usually with diplopia)
aLimitation of motion at extremes of gaze
bEvident restriction of motion
cFixation of a globe or globes

VCorneal involvement (primarily due to lagophthalmos)
aStippling of cornea
cClouding, necrosis, and perforation

VISight loss (due to optic nerve involvement)
aDisc pallor or choking, or visual field defect, vision 20/20–20/60
bThe same, but vision 20/70–20/200
cBlidness, vision less than 20/200

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