Jan 122019

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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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. Table 2 summarises some key points to consider. Quantitative slit lamp observations in contact lens practice.

However, although all the scales are in agreement that red colouration increases with scale grade, with pictorial scales Efron and Annunziato blood vessels become more prominent with initial scale grades and are then replaced by increasing severity of papillae both identified by edge detection. 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.

Social media and SEO success Seven ways: Indeed it is estimated that overcopies of these scales — usually in the form of laminated A4 reference cards but also in large poster format — have been provided to practitioners in the past 20 years. Whilst Efron overcomes these difficulties by encouraging artistic clarity and licence so as to emphasise and isolate the condition that is being evaluated, it is considered by some a departure from the real life situation in as much as different conditions feed and depend on each other and, therefore, occur simultaneously and should appear as such in a single image.

Computerised grading — note the slider at the bottom of the screen allowing easy adjustments of severity. By grading to decimal places that are representative of points in between two successive integer points on the scale, 1.

Wolffsohn JSPurslow C.


Evaluation of the range of areas of the fluorescein staining patterns of the tarsal conjunctiva in man. 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 cc,ru other forms of grading scales. Automatic quantitative measurement of ocular hyperaemia.


Approaches to this challenge are still emerging and gradlng developments in this area are anticipated. Analysis of microvascular network in bulbar conjunctiva by image processing. A modern grading scale adapted for smartphone use.

Such scales vary in the number of images and conditions of interest and can be descriptive, 1, 2 artistically rendered, 3 photographic, 4— 6 or computer generated. Am J Optom Physiol Opt scae Grading features such as palpebral hyperaemia, palpebral roughness, and corneal staining is complex and there is a compromise between the simplicity csale a single scale and the ability to fully describe and monitor changes in the feature.

However, image analysis would have merit in monitoring changes in individual patients with time and the computer could also count the number of segments dcale to identify between punctate and confluent type stainingprovide a ratio of the longest to the shortest axis to give an indication of shape in addition to the measures of edges detected a stable indicator of area and green colouration stain intensity. A new computer assisted objective method for quantifying vascular changes of the bulbar conjunctivae.

Edge detection techniques are local rather than global in nature and examine the surrounding pixels to determine the presence of edges vessels or areas of staining.

Edge detection filled symbols and relative red colouration open symbols with grading scale images of bulbar hyperaemia. Table 1 summarises the benefits. Therefore this study aimed to determine, by objective image analysis, whether commonly used clinical pictorial and photographic subjective grading scales are incremental in nature.

EFRON-CCLRU GRADING SCALES for (Android) Free Download on MoboMarket

Practitioners who use photography to document complications admit, in many cases, to also use grading scales. They conclude that grading scales that are too coarse generally allow less sensitivity in the detection of meaningful clinical changes. Therefore an epithelial scratch, punctate staining, and confluent ulceration could all have similar intensity of green colouration and edge detected area. There has been much discussion and debate in the literature concerning the merits and relative difficulties of constructing photographic versus pictorial grading scales, with the suggestion that painted grading scales, although not as realistic as photographs, allow more control in depicting incremental increases in severity that are clear and unambiguous to the clinician.


The occasional apparent reversal in severity in several of the scales could arise from deficiencies in the scale images, such as the lack of an appropriate photographic image taken with similar perspective and illumination or from scale designers considering a range of feature characteristics to assess the grade of an image.

Key factors in the subjective and objective assessment of conjunctival erythema. In order to improve and standardise anterior eye evaluations between practitioners, subjective grading scales were first popularised back in the mids. If we are working in settings where patients are being seen by multiple practitioners, it is critical that the same scales be used and the same rules applied, to ensure that numbers assigned to appearance by different practitioners match.

A report can then be exported for practice records without collecting patient personal data. As most eyes only have minimal hyperaemia and corneal staining 14, 23, 24 this approach to grading scale design could be considered appropriate, but could lead to errors if clinicians interpolate between scale grade images to improve sensitivity. This is difficult for software to achieve accurately.

Fight for Sight retinoblastoma Fight for Sight launches retinoblastoma research campaign. Guillon MShah D. Palpebral hyperaemia and staining grading is complicated by the variable presentations possible. Clinical monitoring of ocular physiology using digital image analysis. More recently computerised image analysis techniques have been used for grading anterior eye characteristics. Computerised grading removes the problem of grading between ratings. This may involve the use of movie sequence of images, a CD for the Efron gratings, a phone sxale, or computer software programs.

Automated measurement of bulbar redness.