How to classify thyroid eye disease?

The most current grading systems of TED are the VISA (vision, inflammation, strabismus, and appearance) classification and the European Group of Graves’ Orbitopathy (EUGOGO) classification. The utility of these grading systems is that both assess severity and activity.

What is a CAS score?

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.

What is CAS in thyroid eye disease?

Clinical Activity Score. • Add 1 point for each finding. • Symptoms. – Pain or pressure in a periorbital or retroorbital distribution. – Pain with upward, downward, or lateral eye movement.

What causes Graves ophthalmopathy?

Cause of Graves’ ophthalmopathy Graves’ ophthalmopathy results from a buildup of certain carbohydrates in the muscles and tissues behind the eyes — the cause of which also isn’t known. It appears that the same antibody that can cause thyroid dysfunction may also have an “attraction” to tissues surrounding the eyes.

What is ICD 10 code for thyroid eye disease?

E05. 00 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E05. 00 became effective on October 1, 2021.

Is thyroid Acropachy specific to Graves?

Thyroid acropachy is a rare extra-thyroid manifestation of autoimmune thyroid disease. It affects about 0.3% of patients with Graves’ disease and often occurs in euthyroid and hypothyroid patients within weeks to many years after treatment of original thyrotoxicosis [1], [2].

Which muscles are affected most commonly in thyroid eye disease?

Background: Rectus muscle involvement in thyroid ophthalmopathy is well documented. The inferior rectus is the most frequently involved, followed by the medial, superior, and infrequently the lateral rectus.

How is Graves ophthalmopathy diagnosed?

A diagnosis of Graves’ orbitopathy is clinical. Thyroid function studies can be helpful, but in some cases are normal. To determine if Graves’ orbitopathy is present, your doctor may require more scans, such as a computerized tomography (CT) scan or MRI, to identify changes in the muscles around the eyes.

What is the difference between exophthalmos and buphthalmos?

In exophthalmos the eye is pushed forward, and therefore excessive conjunctiva is visible. In buphthalmos, the eye is stretched but remains in its normal position inside the orbit. Therefore, excess conjunctiva is usually not visible.

What hormone is responsible for exophthalmos?

The hormones are called thyroxine and triiodothyronine, and they are normally kept in balance. Thyroid eye disease is a condition where the soft tissues and muscles around the eyes become swollen and inflamed.