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Hyperthyroidism

American Thyroid Association Quick-Reference GUIDELINES Apps

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13 Table 7. GO Severity Assessment Grade a Lid retraction Soft tissues Proptosis b Diplopia Corneal exposure Optic nerve status Mild <2 mm Mild involvement <3 mm Transient or absent Absent Normal Moderate ≥2 mm Moderate involvement ≥3 mm Inconstant Mild Normal Severe ≥2 mm Severe involvement ≥3 mm Constant Mild Normal Sight threatening Severe Compression Upper limits of normal African American F/M = 23/24 mm White F/M = 19/21 mm Asian F/M = 16/17 mm (ai) or 18.6 mm (Chinese) a Mild GO: patients whose features of GO have only a minor impact on daily life, generally insufficient to justify immunosuppressive or surgical treatment. Moderate-to-severe GO: patients without sight-threatening GO whose eye disease has sufficient impact on daily life to justify the risks of immunosuppression (if active) or surgical intervention (if inactive). Sight-threatening GO: patients with dysthyroid optic neuropathy and/or corneal breakdown. is category warrants immediate intervention. b Proptosis refers to the variation compared to the upper limit of normal for each race/ sex or the patient's baseline, if available. Sources: Adapted from de Juan et al. Arch Intern Med. 1980;140:1230-1231, Sarinnapakorn et al. J Med Assoc. ai 2007;90:679-683, Tsai et al. Eye (Lond) 2006;20:569-573 and Bartalena et al. yroid 2008;18:333-346.

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