IER Grading Scales: Vision Cooperative Research Centre, Institute for Eye Research, University of New South Wales

Application of Grading Scales

Patient management is based on how much the normal ocular appearance has changed. In general, a rating of slight (grade 2) or less is considered within normal limits for a population (except staining). A change of one grade or more at follow-up visits is considered clinically significant.

1. VERY SLIGHT	2. SLIGHT	3. MODERATE	4. SEVERE
BULBAR REDNESS
LIMBAL REDNESS
LID REDNESS (area 2)
LID ROUGHNESS: WHITE LIGHT REFLEX (areas 1, 2)
LID ROUGHNESS: FLUORESCEIN (area 2)
POLYMEGETHISM
CORNEAL STAINING: TYPE
CORNEAL STAINING: DEPTH
CORNEAL STAINING: EXTENT (area 5)
CONJUNCTIVAL STAINING

Adverse Responses With Contact Lenses

Infiltrates

Accumulation of inflammatory cells in corneal subepithelium or stroma

• Signs:

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    Whitish opacity (local) or grey haze (diffuse)

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    Mostly 2–3 mm from limbus

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    Localized redness

• Symptoms:

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    Asymptomatic or scratchy, foreign body sensation

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    Redness, tearing and photophobia possible