The VISA classification was developed in Vancouver and is a clinical recording form designed for the office which allows various aspects of the disease to be logically evaluated and recorded to allow appropriate management.

It separates the various clinical features of TED into four parameters:

V (vision, optic neuropathy)

I (inflammation, congestion)

S (strabismus, motility restriction)

A (appearance, exposure).

ITEDS has modified these recording forms by consensus of its members and adopted them as their standardized office record.

Copies of the two page initial visit form and the single page follow-up form may be downloaded (in pdf format) for office use from the public downloads menu at the top of this page.

The basic visit form includes the four sections recording historical symptoms on the left and signs on the right. After each section is a progress row (better, same, worse = s,b,w), recording both the patient’s and clinician’s impression of the course of the disease since the last visit. This allows determination of the phase of the disease:  active (inflammatory) or inactive (quiescent).

The layout is designed to simplify data recording and possible later research data collation. Individual measurements may be completed in as much or little detail as the clinician chooses. At the end of the form is a summary grade for the activity and severity for each of the four disease parameters and a space for investigations and management plan.

On the first visit, the date and rate of onset of both the systemic and orbital symptoms should be recorded, since this may help predict the ultimate severity of the inflammatory phase.