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Back| Grade | Description |
|---|---|
| Grade 0 | No symptoms or signs |
| Grade 1 | No symptoms, only signs. Signs include upper eyelid retraction, staring, and delayed downward movement of the upper eyelid when looking down. Proptosis within 18mm. |
| Grade 2 | Soft tissue involvement, with symptoms and signs such as foreign body sensation, tearing, photophobia, conjunctival edema, tearing, and eyelid thickening. |
| Grade 3 | Proptosis, proptosis greater than 18mm. |
| Grade 4 | Extraocular muscle involvement. |
| Grade 5 | Corneal involvement. |
| Grade 6 | Optic nerve involvement, decreased vision. |
Explanation
The higher the grade, the more severe the condition. Graves' ophthalmopathy can be diagnosed at Grade 3 or above. Among patients with ophthalmopathy, 60% are mild, and about 40% are more severe.
TAO, Thyroid-Associated Ophthalmopathy; TH, Thyroid Hormone.
Symptoms and signs alone cannot reflect the severity of the condition. If necessary, measure palpebral fissure width, proptosis, eye movement (extraocular muscle function), visual field, and vision. TAO can manifest as non-infiltrative or infiltrative proptosis. The former is mainly related to increased sympathetic excitability caused by excessive TH, with common eye signs including: ① Proptosis, upper eyelid retraction, ② Increased palpebral fissure width (Dalrymple sign), ③ Lower lid lag (von Graefe sign), ④ Decreased blinking (Stellwag sign), ⑤ Frightened appearance, ⑥ Inability to wrinkle forehead skin when looking up (Toffroy sign), ⑦ Decreased or absent convergence (Mobius sign).
