Skip to main content

Table 2 TAO Eye changes classification - NOSPECS

From: Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface

Class Grade Criteria
1   No physical signs or symptoms
  Only signs (limited to upper lid retraction, stare, and lid lag)
2   Soft tissue involvement (with symptoms and signs)
0 Absent
a Minimal
b Moderate
c Marked
3   Proptosis ≥3 mm above upper normal limit
0 Absent
a 3–4 mm increase over upper normal
b 5–7 mm increase
c ≥8 mm increase
4   Extraocular muscle involvement
0 Absent
a Limitation of motion extremes of gaze
b Evident restriction of motion
c Fixation of a globe or globes
5   Corneal involvement
0 Absent
a Stippling of cornea
b Ulceration
c Clouding, necrosis, perforation
6   Sight loss (optic nerve involvement)
0 Absent
a Disc pallor or visual field deffect; vision 20/20–20/60
b Same as 6a, but vision 20/70–20/200
c Blindness, i.e., failure to perceive light, vision < 20/200