Modification of the classification of the eye changes of Graves' disease.

The original (1969) classification of the Eye Changes of Graves' Disease has been retained except for Classes 1 and 3. Class 1 has been limited so that proptosis of 23 mm or greater is placed in Class 3, even if the patient is asymptomatic. Grading of Classes 1 and 2 has been left to the individual physician or clinic, but we urge that the suggested criteria for grading Classes 3 through 6 be used. Progression of disease is not necessarily sequential through each of the classes, and ethnic factors and myopia may influence the extent of proptosis in normal subjects.