Clinical Activity Score (Thyroid Eye Disease)

Clinical Activity Score (Mourits 1989; EUGOGO) for thyroid eye disease / Graves orbitopathy — a 7-item initial-assessment measure of disease activity.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Spontaneous orbital (retrobulbar) pain
Yes
Gaze-evoked orbital pain
Yes
Eyelid swelling
Yes

Result: Clinical Activity Score 3 of 7: active thyroid eye disease (CAS >= 3).

The tool opens with these values already filled in. Replace them with your own.

What the result means

CAS 0-2
Inactive by CAS: below the >= 3 activity threshold.
CAS >= 3
Active thyroid eye disease; the classically taught threshold for considering anti-inflammatory treatment.

What you enter

  • Spontaneous orbital (retrobulbar) pain
  • Gaze-evoked orbital pain
  • Eyelid swelling (active TED)
  • Eyelid erythema
  • Conjunctival redness (active TED)
  • Chemosis
  • Inflammation of the caruncle or plica
How this is calculated
Items
One point each: spontaneous orbital pain, gaze-evoked pain, eyelid swelling, eyelid erythema, conjunctival redness, chemosis, caruncle/plica inflammation.

Mourits MP, Koornneef L, Wiersinga WM, et al. Clinical criteria for the assessment of disease activity in Graves ophthalmopathy: a novel approach. Br J Ophthalmol. 1989;73(8):639-644. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.