LEMO Classification

Table of contents

1. Definition

2. Graduation

2.1. Lid Affection (L)
2.2. Exophthalmus (E)
2.3. Muscular Affection (M)
2.4. Optical Nerve Affection (O)

3. References

Definition

LEMO Classification is faceted classification that provides a modern and differentiated approach for staging endocrine opthalmopathy. It is intended to complement the NOSPECS Scheme. Four finding-categories "lid affections", "exophthalmus", "muscular affection" and "optical nerve affection" are associated with integer values between 0 and 4, depending on the grade of severity.

LEMO Classification has first been suggested in 1991 by Boergen and Pickardt.

Graduation

Lid Affection (L)

0: missing
1: lid edema only
2: real retraction (impaired lid closing)
3: retraction and upper lid edema
4: retraction and global lid edema

Exophthalmus (E)

0: missing
1: eye closing not impaired
2: conjunctival injection in the morning
3: persistent conjunctival injection
4: corneal complications

Muscular Affection (M)

0: missing
1: detectable in imaging only
2: Pseudoparesis
3: Pseudoparalysis

Optical Nerve Affection (O)

0: missing
1: regarding color vision only or detected via VEP
2: peripheral scotoma
3: central scotoma

Thus, the stadium L1E1M2O0 denotes endocrine opthalmopathy with lid edema, exophthalmus and pseudoparesis of external eye muscles.