Review Article

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

Table 2

Clinical Activity Score (CAS) (amended by EUGOGO after Mourits et al.). One point is given for the presence of each of the parameters assessed. The sum of all points defines clinical activity: active ophthalmopathy if the score is above 3/7 at the first examination or above 4/10 in successive examinations.

For initial CAS, only score items 1–7

1Spontaneous orbital pain
2Gaze evoked orbital pain
3Eyelid swelling that is considered to be due to active GO
4Eyelid erythema
5Conjunctival redness that is considered to be due to active GO
7Inflammation of caruncle OR plica

Patients assessed after follow-up (1–3 months) can be scored out of 10 by including items 8–10

8Increase of >2 mm in proptosis
9Decrease in uniocular ocular excursion in any one direction of >8°
10Decrease of acuity equivalent to 1 Snellen line