The Ophthalmopathy Index proposed by Donaldson et al was intended for the classification and grading of Graves' ophthalmopathy. It is based on the 5 classes of the original American Thyroid Association classification of Graves' ophthalmopathy. Several modifications have been proposed to address the limitations of the original schema.
Acronym SPECS:
Soft tissue
Proptosis
Extra-ocular muscle
Cornea
Sight loss
|
Involvement Category |
Degree of Involvement |
Points |
|
Soft Tissue (Class 2) |
minimal |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
Proptosis (Class 3) by Krahn exophthalmometer |
minimal (20-23 mm) |
1 |
|
|
moderate (> 23 - 27 mm) |
2 |
|
|
marked (> 27 mm) |
3 |
|
Extra-ocular muscle (Class 4) |
minimal |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
Cornea (Class 5) |
minimal |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
Sight loss (Class 6) |
minimal |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
Ophthalmopathy Index =
= SUM(points for all 5 categories)
Interpretation:
• minimum score: 0
• maximum score: 15
Limitations:
• The score may change opposite to severity of ophthalmopathy. For example, the score could decrease with development of optic neuropathy if there is improvement in soft tissue signs.
• There is wide variation in grading between observers.
• The index does not always provide a numerical response to treatment comparable to clinical response.
Specialty: Ophthalmology, Endocrinology
ICD-10: ,
