Review Article

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

Table 3

VISA Inflammatory Index (I) (Dolman and Rootman 2006 [25], ITEDS modified). Patients with moderate inflammatory index (less than 4 of 10) are managed conservatively. Patients with high scores (above 5 of 10) or with evidence of progression in the inflammation are offered a more aggressive therapy.

Sign or symptomScore

Caruncular edema 0: absent
1: present

Chemosis0: absent
1: conjunctiva lies behind the grey line of the lid
2: conjunctiva extends anterior to the grey line of the lid

Conjunctival redness 0: absent
1: present

Lid redness0: absent
1: present

Lid edema 0: absent
1: present but without redundant tissues
2: present and causing bulging in the palpebral skin, including lower lid festoon

Retrobulbar ache
At rest
With Gaze

0: absent; 1: present
0: absent; 1: present

Diurnal variation0: absent; 1: present