ABSTRACT

One of the challenges in thyroid-related orbitopathy (TO) is how to classify and grade its various clinical manifestations. Over the past few decades, numerous classifications have been devised (1), including Werner’s NO SPECS classification (1969) that graded symptoms and signs associated with the disease (2), Bahn and Gorman’s focus on measuring objective and reproducible criteria (3), and Mourits et al.’s clinical activity score for grading the inflammatory phase of the disease (4).