Research Article

Consensus on Severity for Ocular Emergency: The BAsic SEverity Score for Common OculaR Emergencies [BaSe SCOrE]

Table 2

Consensus reached on items from the 4 main categories of ocular emergencies and sorted by median weight rating severity.

CategoryItemOpinion submittedMedian weightsQuartile [1st; 3rd]
Yes ()No ()

Anterior segment items
ConjunctivitisNoninfectious7461 [1.0; 1.0]
KeratitisSuperficial punctate keratitis7371[1.0; 1.0]
Contact lensMechanical complication (dislocation, vacuum, etc.)7461[1.0; 2.0]
PterygiaInflamed pterygia7461[1.0; 2.0]
ConjunctivitisViral conjunctivitis7462[1.0; 2.0]
Scleral and episcleral inflammationEpiscleritis (regardless of the cause)7462[1.0; 2.0]
Corneal ulcer (not infected)Unperforated—isolated epithelial defect7372[1.0; 3.0]
ConjunctivitisBacterial conjunctivitis7462[2.0; 2.0]
KeratitisNoninfectious interstitial keratitis7282[2.0; 3.0]
Anterior acute uveitisFirst episode (regardless of the cause)7282[2.0; 3.0]
Contact lensInfectious keratitis without severity factor7463[2.0; 3.0]
Anterior acute uveitisIterative (regardless of the cause)7373[2.0; 3.0]
Scleral and episcleral inflammationScleritis (regardless of the cause)7463[2.0; 3.0]
Lacrimal ductsAcute dacryocystitis7373[2.0; 3.0]
Corneal ulcer (not infected)Unperforated, with stromal involvement7463[2.0; 4.0]
KeratitisInfectious keratitis7373[3.0; 4.0]
Ocular surface burn <9 clock hours of limbus and <75% of conjunctiva7373[3.0; 4.0]
Contact lensInfectious keratitis with severity factor(s) 7464[4.0; 5.0]
GlaucomaAcute angle-closure glaucoma7374[4.0; 5.0]
GlaucomaNeovascular glaucoma7374[4.0; 5.0]
Corneal ulcer (not infected)Perforating ulcer7465[5.0; 5.0]

Posterior segment items
Nonspecific visual symptomsOphthalmic migraine70101[1.0; 2.0]
Nonspecific visual symptomsVitreous floaters70101[1.0; 2.0]
Choroidal new vessels (CNV) or direct complicationPeripheral (exclusively)70102[2.0; 3.0]
MaculaMacular edema7193[2.0; 3.0]
Chorioretinal toxoplasmosis (active phase)Peripheral7193[2.0; 3.0]
Pupil disordersNo oculomotor disturbance7193[2.0; 3.0]
Retinal peripheral tearNo detached edges, no RD associated70103[2.0; 3.0]
Chorioretinal toxoplasmosis (active phase)Vitreous hemorrhage—isolated/unidentified cause7193[2.0; 4.0]
Acute binocular diplopiaWithout neurological symptoms7193[2.0; 4.0]
MaculaMacular hole70103[2.0; 4.0]
Optic neuritis (regardless of the cause)Without neurological symptoms7193[3.0; 4.0]
Retinal vein occlusionBranch (BRVO)70103[3.0; 4.0]
Retinal peripheral tearDetached edges, no RD associated70103[3.0; 4.0]
Posterior segment inflammationVitritis (unidentified etiology)70103[3.0; 4.0]
Posterior segment inflammationRetinal vasculitis7194[3.0; 4.0]
Retinal artery occlusionBranch (BRAO)70104[3.0; 4.0]
Choroidal new vessels (CNV) or direct complicationSubfoveal70104[3.0; 4.0]
Optic neuritis (regardless of the cause)With associated neurological symptoms7194[3.0; 5.0]
Pupil disordersAssociated with oculomotor disturbance7194[3.0; 5.0]
Retinal vein occlusionCentral (CRVO)70104[3.0; 5.0]
Ischemic optic neuropathyIsolated69114[3.0; 5.0]
Retinal detachment (RD)Macula off7194[4.0; 5.0]
Chorioretinal toxoplasmosis (active phase)Foveal or peripapillary7194[4.0; 5.0]
Retinal detachment (RD)Macula on7195[4.0; 5.0]
Acute binocular diplopiaWith associated neurological symptoms7195[4.0; 5.0]
Retinal artery occlusionCentral (CRAO)69115[4.0; 6.0]

Traumatisms items
ConjunctivaSubconjunctival hemorrhage7191[0.0; 1.0]
ConjunctivaConjunctival wound without scleral exposure7191[1.0; 2.0]
Corneal injuryCorneal foreign body away from the axis7192[1.0; 2.0]
Other injuriesEyelid skin injury7192[1.0; 2.0]
ConjunctivaConjunctival wound with scleral exposure7192[2.0; 3.0]
Corneal injuryNonperforating laceration away from the axis7192[2.0; 3.0]
Commotio retinaePeripheral posttraumatic retinopathy70102[2.0; 3.0]
Corneal injuryCorneal foreign body in the visual axis7193[2.0; 3.0]
Blunt injuries with impaired visionHyphema (isolated)7193[2.0; 3.0]
Other injuriesEyelid-margin injury7193[2.0; 3.0]
Other injuriesEyelid levator injury7193[3.0; 3.0]
Corneal injuryNonperforating laceration in the visual axis7193[3.0; 4.0]
Commotio retinaePosttraumatic maculopathy70103[3.0; 4.0]
Blunt injuries with impaired visionIridodialysis (avulsion of the iris root)7193[3.0; 4.0]
Other injuriesTear ducts injury7193[3.0; 4.0]
Corneal injuryPerforating but self-sealing laceration70104[3.0; 4.0]
Blunt injuries with impaired visionChoroidal rupture7194[3.0; 4.0]
Blunt injuries with impaired visionLens dislocation7194[3.0; 5.0]
Penetrating eye injuryWithout intraocular foreign body, eye not collapsed7194[4.0; 5.0]
Corneal injuryPerforating and leaking laceration7195[4.0; 5.0]
Penetrating eye injuryWith intraocular foreign body, eye not collapsed7195[4.0; 5.0]
Blunt injuries with impaired visionScleral rupture7195[4.0; 5.0]
Other injuriesOptic nerve injury7195[4.0; 5.0]
Penetrating eye injuryWithout intraocular foreign body, eye collapsed7195[5.0; 5.0]
Penetrating eye injuryWith intraocular foreign body, eye collapsed7195[5.0; 6.0]

Items from complication following ocular surgery
Acute painWith normal postoperative course69112[2.0; 3.0]
High intraocular pressure (except AACG)25 < IOP < 35 mmHg69112[2.0; 3.0]
Suture-related complicationNoninfectious suture-related complication70102[2.0; 3.0]
High intraocular pressure (except AACG)IOP = 35 mmHg or IOP > 35 mmHg67133[3.0; 4.0]
Laser keratomileusis in situ (LASIK)Complication related to the flap70103[3.0; 4.0]
Keratoplasty (corneal grafting procedure)Suture-related complication (no infection)70103[3.0; 4.0]
Intraocular hemorrhageWithin 3 days after the surgery70104[3.0; 4.0]
Keratoplasty (corneal grafting procedure)Acute rejection70104[3.0; 5.0]
Mechanical complication following surgeryReopening of the surgical wound68124[3.0; 5.0]
Suture-related complicationInfectious suture-related complication69114[3.0; 5.0]
Mechanical complication following surgeryCollapsed eyeball (athalamia)61194[4.0; 5.0]
Keratoplasty (corneal grafting procedure)Graft dislocation70105[4.0; 5.0]
Infection following surgeryBlebitis70105[4.0; 5.0]
Infection following surgeryPanophthalmitis70105[5.0; 6.0]