Contact Lenses Grading Scales. Etiology. Normal grade. Comment. Bulbar redness. Dilation of bulbar vessels, e.g. due to mechanical stimulation. CCLRU O GRADING SCALES. CCLRU. SCCLRU. BULBAR REDNESS. SLIGHT. 2. SLIGHT. 3. MODERATE. SEVERE. OCCLRU. LIMBAL. Eye care professionals: See the Efron Grading Scales for a standard clinical reference for describing the severity of 16 contact lens complications.

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CLAO J ; An area of approximately 90 pixels about 6. Most practitioners graded to the nearest whole unit A general increase in edges detected with increasing scale grade was seen in the all the scales analysed, although the change in green colouration was more variable.

Gradimg scales are well established as aids to assist in the monitoring of anterior eye characteristics. A novel grading method for superficial punctate keratopathy magnitude and its correlation with corneal epithelial permeability. Paper records may also have specific sections for recording clinical information, as well as previously drawn ocular sketches for annotation.

Characteristics of corneal staining in hydrogel contact lens wearers. Although computers and slit lamp biomicroscope cameras are becoming more common in hospitals and eye care practices, printed grading scales have the advantage of being inexpensive and portable.

This is perhaps not surprising, given that these are common complications often related to patient symptoms and also the subject of extensive discussion in the literature and at conferences.

Quantitative slit lamp observations in contact lens practice. Further investigation of the palpebral response to stimuli such as antigens, toxic chemicals, and mechanical effects is required to determine whether the response is similar and how it should be best depicted or photographed for grading purposes.


Ophthal Physiol Opt ; Researchers have examined the repeatability of discrete and continuous anterior segment grading. Slit lamp classification system. Ideally, prior to contact lens wear, the baseline data for a range of clinical variables should be collected and then be continually monitored throughout the course of the patients wearing experience.

Evaluation of the range of areas of the fluorescein staining patterns of the tarsal conjunctiva in man. Increments of scales used. Examples of more recently introduced grading scales.

Incremental nature of anterior eye grading scales determined by objective image analysis

Int Contact Lens Clinics ; These alternative approaches to record keeping can all be considered as representing good clinical practice. The increments of the grading scales were best described by a quadratic rather than a linear function. The objective grading of ocular redness involves judgement of both the hue and vessel size, relative to the area under question.

Highlighting the papillae with fluorescein would appear a more appropriate method for determining palpebral roughness as previously described, 25, 26 causing an increase in edges detected and a decrease in the fluorescein coverage, despite an apparent decrease in severity with the highest CCLRU scale grade.

They allow for an accurate means of detecting change that can occur gradimg lens use and provide the practitioner with the necessary information to intervene to minimise the risk of a chronic adverse reaction to the contact lens. Editor’s choice Look local: Practitioners must record the grading scale used, and ideally standardise this within an individual practice or corporate groups.


As with the other scales analysed, grades are not comparable between grading scales as has previously been shown objectively. Open in a separate window.

Incremental nature of anterior eye grading scales determined by objective image analysis

Annunziato and Efron pictorial, and CCLRU and Vistakon-Synoptik photographic grades of bulbar hyperaemia, palpebral hyperaemia roughness, and corneal staining were analysed. Int J Microcirculation Clin Exp ; 6: Key factors in the subjective and objective assessment of conjunctival erythema.

Practitioners often overcome this limitation by adopting half-point scales, or by assigning plus and minus symbols next to an integer scale. Please review our privacy policy. Fight for Sight retinoblastoma Fight for Sight launches retinoblastoma research campaign. The app enables levels of scalees to be compared side-by-side in 0. Example of edge detection and colour extraction techniques applied to a selected dashed rectangle area of an image of bulbar hyperaemia. Wolffsohn JSPurslow C.

Variability of clinical researchers in contact lens research. The scale rate was 31 per cent. J Br Contact Lens Assoc ; The objective computer image analysis grading techniques used in these studies have not yet been generally used in clinical practice.