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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Lies, statistics, and clinical significance.

Grading scales for contact lens complications. Another concern with existing clinical grading scales is that they do not cover all possible clinical appearances, particularly at the severe end of the scalw, and that they may not be linear.

Vistakon-Synoptik palpebral conjunctivitis images were analysed selecting the palpebral hyperaemia and the area with reflections separately to distinguish between hyperaemia and roughness.

Int J Microcirculation Clin Exp ; gradlng This may involve the use of movie sequence of images, a CD for the Efron gratings, a phone app, or computer software programs. Two important recent studies help us to reach a more standardised approach. Word description, sketches and grading scales were used more for recording the anterior eye health of contact lens wearers than other patients, but photography was used by a similar number.

Evaluation of the range of areas of the fluorescein staining patterns of the tarsal conjunctiva in man. Invest Ophthalmol Vis Sci ; The BHVI photographic scales have been criticised for the lack of perfect homogeneity between images representing the same condition, either in terms of different illumination conditions or variability of size of the area under display.

Southwest Independent Institutional Review Board, Xcale novel grading method for superficial punctate keratopathy magnitude and its correlation with corneal epithelial permeability.


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

Characteristics of corneal staining in hydrogel contact lens wearers. These alternative approaches to record keeping can all be considered as representing good clinical practice.

In order to improve and standardise anterior eye evaluations between practitioners, subjective grading scales were first popularised back in the mids. This is difficult for software to achieve accurately. J Br Contact Lens Assoc ; J Allergy Clin Immunology ; In conclusion, the printed grading scales analysed were quadratic in nature, having a higher sensitivity for grading features of low severity.

Both clinical grading scales have been published in prominent textbooks and widely distributed around the world, free of charge, by several major contact lens companies. Colour extraction has face validity 28 and examines global relative colouration red for hyperaemia and green for staining. Image analysis techniques are 6—35 times more repeatable than subjective grading, with a sensitivity of 1. Fight for Sight retinoblastoma Fight for Sight launches retinoblastoma research campaign.

The benefits of clinical grading scales include accuracy and consistency in clinical record keeping leading to more meaningful communication of clinical cases to fellow health professionals.

Computerised grading removes the problem of grading between ratings. Computerised grading — note the slider at the bottom of the screen allowing easy adjustments of severity.


The objective computer image analysis grading techniques used in these studies have not xcale been generally used in clinical practice. Am J Ophthalmol ; All the staining extent scales analysed, except the Vistakon-Synoptik scale, depicted more than one type of staining and therefore assessing the ability of image analysis measures to determine the severity of staining is complicated.

Paper records may also have specific sections for recording clinical information, as well as previously drawn ocular sketches for annotation. Grading conjunctival hyperaemia using a photography-based method.

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CCLRU grading scale | Optometric | Pinterest | Eyes, Lens and Education

Table 1 summarises the benefits. Compared with reported values of clinician subjective grading variability using these grading scales, 7, 9, 12, 15 image analysis techniques are approximately 6—35 times more repeatable, with a sensitivity of 2. Another interesting finding was that grading scales are more likely to be used by optometrists who have recently graduated, have a postgraduate certificate in ocular therapeutics, see more contact lens patients or use other forms of grading scales.

How to choose a lab Looking at labs: Although the difference is again within the variability of clinical grading 7 and relative change will govern clinical decision making, individual grading strategies will increase the variance between individuals, and hence decrease the statistical power sale clinical research studies or the ability of clinicians to monitor small changes over time.

The intensity, incidence angle, and type of illumination will affect the reflections as well as the apparent size and shape of the papillae, and therefore the non-uniform change with increasing photographic scale intensity may be expected. Grading features such as palpebral hyperaemia, palpebral roughness, and corneal staining is complex and there is a compromise between the simplicity of a single scale and the ability to fully describe gradimg monitor changes in the feature.

Edge detection and colour extraction image analysis techniques are highly repeatable and offer the potential for more repeatable and sensitive grading than using printed subjective grading scales.

Palpebral hyperaemia gradkng staining grading is complicated by the variable presentations possible.