Limbal and Bulbar Hyperaemia in Normal Eyes
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...
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| Veröffentlicht in: | Ophthalmic & physiological optics 2008-01, Vol.28 (1), p.13-20 |
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| creator | Pult, Heiko Murphy, Paul J. Purslow, Christine Nyman, Jeffrey Woods, Russell L. |
| description | 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 |
| doi_str_mv | 10.1111/j.1475-1313.2007.00534.x |
| format | Article |
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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.</description><identifier>ISSN: 0275-5408</identifier><identifier>EISSN: 1475-1313</identifier><identifier>DOI: 10.1111/j.1475-1313.2007.00534.x</identifier><identifier>PMID: 18201331</identifier><identifier>CODEN: OPOPD5</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; bulbar hyperaemia ; bulbar redness ; clinical grading ; Conjunctiva - blood supply ; Conjunctiva - pathology ; Epidemiologic Methods ; Eye and associated structures. Visual pathways and centers. Vision ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Hyperemia - pathology ; limbal hyperaemia ; limbal redness ; Limbus Corneae - blood supply ; Limbus Corneae - pathology ; Male ; Medical sciences ; Middle Aged ; normal ; Ophthalmology ; Reference Values ; Vertebrates: nervous system and sense organs</subject><ispartof>Ophthalmic & physiological optics, 2008-01, Vol.28 (1), p.13-20</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5154-c9f006383da3ecfa992f64675d3365cdf039a2614dab67eec76bb3fcb7c36f1a3</citedby><cites>FETCH-LOGICAL-c5154-c9f006383da3ecfa992f64675d3365cdf039a2614dab67eec76bb3fcb7c36f1a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1475-1313.2007.00534.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1475-1313.2007.00534.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19988276$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18201331$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pult, Heiko</creatorcontrib><creatorcontrib>Murphy, Paul J.</creatorcontrib><creatorcontrib>Purslow, Christine</creatorcontrib><creatorcontrib>Nyman, Jeffrey</creatorcontrib><creatorcontrib>Woods, Russell L.</creatorcontrib><title>Limbal and Bulbar Hyperaemia in Normal Eyes</title><title>Ophthalmic & physiological optics</title><addtitle>Ophthalmic Physiol Opt</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>bulbar hyperaemia</subject><subject>bulbar redness</subject><subject>clinical grading</subject><subject>Conjunctiva - blood supply</subject><subject>Conjunctiva - pathology</subject><subject>Epidemiologic Methods</subject><subject>Eye and associated structures. Visual pathways and centers. Vision</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Hyperemia - pathology</subject><subject>limbal hyperaemia</subject><subject>limbal redness</subject><subject>Limbus Corneae - blood supply</subject><subject>Limbus Corneae - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>normal</subject><subject>Ophthalmology</subject><subject>Reference Values</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0275-5408</issn><issn>1475-1313</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1LwzAUhoMoOqd_QXqjN9Ka9LRJC97o_JgwnAN1l-E0TaCz3Way4fbvTd2Yl5qbHDjPk3PyEhIwGjF_riYRS0QaMmAQxZSKiNIUkmi1Rzq7xj7p0NjXaUKzI3Ls3IR6UojskByxLKYMgHXI5aBqCqwDnJbB7bIu0Ab99Vxb1E2FQTUNnme28f37tXYn5MBg7fTp9u6St4f7114_HAwfn3o3g1ClLE1ClRtKOWRQImhlMM9jwxMu0hKAp6o0FHKMOUtKLLjQWgleFGBUIRRwwxC65GLz7tzOPpfaLWRTOaXrGqd6tnRS0Nh_gOd_gpDEALnfpUuyDajszDmrjZzbqkG7lozKNlE5kW1wsg1OtonKn0Tlyqtn2xnLotHlr7iN0APnWwCdwtpYnKrK_XJ5nmWxaHe43nBfVa3X_15ADl-GvvB6uNErt9CrnY72Q3IB3hw_P8rB6O69P85GcgzfMfGeYQ</recordid><startdate>200801</startdate><enddate>200801</enddate><creator>Pult, Heiko</creator><creator>Murphy, Paul J.</creator><creator>Purslow, Christine</creator><creator>Nyman, Jeffrey</creator><creator>Woods, Russell L.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U5</scope><scope>8FD</scope><scope>L7M</scope><scope>7X8</scope></search><sort><creationdate>200801</creationdate><title>Limbal and Bulbar Hyperaemia in Normal Eyes</title><author>Pult, Heiko ; Murphy, Paul J. ; Purslow, Christine ; Nyman, Jeffrey ; Woods, Russell L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5154-c9f006383da3ecfa992f64675d3365cdf039a2614dab67eec76bb3fcb7c36f1a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>bulbar hyperaemia</topic><topic>bulbar redness</topic><topic>clinical grading</topic><topic>Conjunctiva - blood supply</topic><topic>Conjunctiva - pathology</topic><topic>Epidemiologic Methods</topic><topic>Eye and associated structures. Visual pathways and centers. Vision</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Hyperemia - pathology</topic><topic>limbal hyperaemia</topic><topic>limbal redness</topic><topic>Limbus Corneae - blood supply</topic><topic>Limbus Corneae - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>normal</topic><topic>Ophthalmology</topic><topic>Reference Values</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pult, Heiko</creatorcontrib><creatorcontrib>Murphy, Paul J.</creatorcontrib><creatorcontrib>Purslow, Christine</creatorcontrib><creatorcontrib>Nyman, Jeffrey</creatorcontrib><creatorcontrib>Woods, Russell L.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Technology Research Database</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmic & physiological optics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pult, Heiko</au><au>Murphy, Paul J.</au><au>Purslow, Christine</au><au>Nyman, Jeffrey</au><au>Woods, Russell L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limbal and Bulbar Hyperaemia in Normal Eyes</atitle><jtitle>Ophthalmic & physiological optics</jtitle><addtitle>Ophthalmic Physiol Opt</addtitle><date>2008-01</date><risdate>2008</risdate><volume>28</volume><issue>1</issue><spage>13</spage><epage>20</epage><pages>13-20</pages><issn>0275-5408</issn><eissn>1475-1313</eissn><coden>OPOPD5</coden><abstract>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><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18201331</pmid><doi>10.1111/j.1475-1313.2007.00534.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences bulbar hyperaemia bulbar redness clinical grading Conjunctiva - blood supply Conjunctiva - pathology Epidemiologic Methods Eye and associated structures. Visual pathways and centers. Vision Female Fundamental and applied biological sciences. Psychology Humans Hyperemia - pathology limbal hyperaemia limbal redness Limbus Corneae - blood supply Limbus Corneae - pathology Male Medical sciences Middle Aged normal Ophthalmology Reference Values Vertebrates: nervous system and sense organs |
| title | Limbal and Bulbar Hyperaemia in Normal Eyes |
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