US EPA

616914 

Journal Article 

Limbal and Bulbar Hyperaemia in Normal Eyes 

Pult, H; Murphy, PJ; Purslow, C; Nyman, J; Woods, RL 

2008 

1 

Ophthalmic and Physiological Optics
ISSN: 0275-5408 

28 

1 

13-20 

Purpose: To investigate the appearance of limbal and bulbar hyperaemia in normal eyes, their relationship and the inter-observer agreement of clinical grading. Methods: The right eyes of 120 healthy, non-contact lens-wearing subjects (m = 57, f = 63, median age = 45 years, range 18–77 years) were examined by two trained observers. Limbal and bulbar hyperaemia were scored using the Cornea and Contact Lens Research Unit (CCLRU) redness grading scales interpolated into 0.1 increments. Redness of four quadrants, and overall, were assessed, and quadrant-average redness was calculated. Inter-observer agreement was assessed at the start and end of the study (20 subjects each). Results: For limbal redness, the overall (1.62 ± 0.46) (mean units ± S.D.) was not significantly different from the quadrant-average (1.61 ± 0.40) score. For bulbar redness, the overall (2.02 ± 0.49) was higher than the quadrant-average (1.82 ± 0.39) score ( p < 0.0001). Significant correlations were found between bulbar and limbal quadrants (Pearson: r ≥ 0.43, p < 0.0001). Significant differences in redness were found between quadrants ( p < 0.0001), with nasal and temporal redder than superior and inferior quadrants. Small effects of age and gender were found for limbal redness. The inter-observer 95% limits of agreement were similar at the start and end of the study. They were larger for overall (0.57) compared with quadrant-average (0.28) redness. Conclusions: For similar populations, a limbal redness above 2.5 or a bulbar redness above 2.6 (quadrant-average) or 3.0 (overall) may be considered abnormal. Limbal and bulbar redness were correlated. Quadrant-average scores are recommended instead of overall scores, as inter-observer agreement was better. [ABSTRACT FROM AUTHOR] Copyright of Ophthalmic & Physiological Optics is the property of Blackwell Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts) 

EYE -- Examination; EYE -- Diseases; EYE -- Inflammation; CONTACT lenses; HYPEREMIA; bulbar hyperaemia; bulbar redness; clinical grading; limbal hyperaemia; limbal redness; normal