Thyroid Storm: eMedicine

Medical Criteria

Medcape. Caso clinico.

Thyroid Disease Manager.

Las siguientes escalas son utiles en la evaluacion clinica de oftalmopatia tiroidea:

a) Puntuación de Actividad Clínica (PAC).

1. Dolor opresivo sobre o detrás del ojo.
2. Dolor con los movimientos oculares.
3. Enrojecimiento palpebral.
4. Enrojecimiento conjuntival.
5. Quemosis.
6. Edema de carúncula.
7. Edema palpebral.

Se clasifica la oftalmopatía como activa con 3 o mas puntos.

NOSPECS

It has first been suggested in 1969 by S.C. Werner and delivers the following classification:

• Class 0: No signs or symptoms
• Class 1: Only signs, no symptoms (e. g. lid retraction)
• Class 2: Soft tissue involvement
• Class 3: Proptosis
• Class 4: Extraocular muscle involvement
• Class 5: Corneal involvement
• Class 6: Sight loss.

Within classes 1 to 6 the investigator has to differentiate the severeity grades 0, A, B, C.

LEMO Classification has first been suggested in 1991 by Boergen and Pickardt.

LEMO classification

• 0: missing
• 1: lid edema only
• 2: real retraction (impaired lid closing)
• 3: retraction and upper lid edema
• 4: retraction and global lid edema

• 0: missing
• 1: eye closing not impaired
• 2: conjunctival injection in the morning
• 3: persistent conjunctival injection
• 4: corneal complications

• 0: missing
• 1: detectable in imaging only
• 2: Pseudoparesis
• 3: Pseudoparalysis

• 0: missing
• 1: regarding color vision only or detected via VEP
• 2: peripheral scotoma
• 3: central scotoma