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Item | 0 | 1 | 2 | 3 |
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Symptoms | | | | |
Itching | No | Occasional | Frequent | Constant |
Tearing | Normal tear | Sensation of fullness of the conjunctival sac | Infrequent spilling of tears over the lid margin | Constant spilling of tears over the lid margin |
Discomfort | Absent | Mild | Moderate | Severe |
Discharge | No | Small amount of mucoid discharge | Moderate amount of mucoid discharge, presence of crust upon awakening | Eyelids tightly matted together on awakening, warm soaks necessary to clean eyelids during day |
Photophobia | No | Mild | Moderate, necessitating dark glasses | Extreme photophobia, even with dark glasses |
Signs | | | | |
Limbal hypertrophy | No | One quadrant | Two quadrants | Three or more |
Bulbar conjunctival hyperemia | Absent | Mild | Moderate | Severe |
Tarsal conjunctival papillary hypertrophy | No | Mild | Moderate | Severe, obscuring the visualization of the deep tarsal vessels |
Keratitis | No | One quadrant | Two quadrants, macroerosion | Three or more quadrants, vernal ulcer |
Neovascularization of cornea | No new vessel formation | Neovascularization in 1 quadrant of cornea | Neovascularization in 2 quadrants of cornea | Neovascularization in 3 or more quadrants of cornea |
Cicatrizing conjunctivitis | No | Presence of subepithelial fibrosis | Presence of fornix foreshortening | Symblepharon formation |
Blepharitis | No | Mild redness and edema of the eyelid with meibomian gland dysfunction | Moderate inflammation with hyperemia, scales and scurf of eyelid skin | Severe inflammation, with cracks in the eyelid skin, loss of eyelashes, and lid edema |
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