CTCAE Grading for Vision Changes

Eye-related irAEs (Including episcleritis, iritis, ocular myositis, scleritis, uveitis)

Grading (grading for the specific etiology would be performed by the ophthalmologist)

  • Asymptomatic or mild changes; clinical or diagnostic observations only; intervention not indicated
  • Moderate; minimal; local or noninvasive intervention indicated; limiting age-appropriate instrumental ADLs
  • Severe or medically significant but not immediately sight-threatening; hospitalization or prolongation of existing hospitalization indicated; disabling; limiting self-care ADLs
  • Sight-threatening consequences; urgent intervention indicated; blindness (20/200 or worse) in the affected eye


  • Encourage patient to report any eye symptom immediately
  • Obtain ophthalmology referral immediately
  • Anticipate ipilimumab holds for any Grade 2 AE; resume when returns to Grade 0 or 1; permanently discontinue for any Grade 3–4 AE, persistent Grade 2 AE lasting ≥6 weeks, or inability to reduce corticosteroid dosage to 7.5 mg/d prednisone or equivalent