Efron Grading Scales

Blepharitis

Signs

Redness
Telangiectasis
Scaling of lid margins
brittle, leaving bleeding ulcer when removed
Lashes stuck together
Lash collarette
Madarosis
Poliosis
Tylosis

Symptoms

Burning
Itching
Mild photophobia
Foreign body sensation
Dry eye - worse in morning
Lens intolerance

Pathology

Staphylococcal endotoxin-induced complications include:
low grade conjunctivitis
toxic punctate epitheliopathy

Aetiology

Staphylococcal infection of eyelash follicle

Treatment

Antibiotic ointments
Promote lid hygiene
Steroids
Artificial tears
May need to suspend lens wear during acute treatment phase

Prognosis

Variable: expect periods of remission and exacerbation

Differential Diagnosis

Need to differentiate from seborrhoeic anterior blepharitis
This content is based on the book: CONTACT LENS COMPLICATIONS, Author NATHAN EFRON Ed: Butterworth-Heinemann, 1999.

The Efron Grading Scales* provide a convenient clinical reference for eye care professionals.

On a scale of 0 to 4, it describes the severity of the following anterior ocular complications that can occur from contact lens wear.

  • Meibomian gland dysfunction
  • Superior limbic keratoconjunctivitis
  • Corneal infiltrates
  • Corneal ulcer
  • Endothelial polymegethism
  • Endothelial blebs
  • Corneal distortion
  • Conjunctival redness
  • Limbal redness
  • Corneal neovascularisation
  • Epithelial microcysts
  • Corneal oedema
  • Corneal staining
  • Conjunctival staining
  • Papillary conjunctivitis

Each condition includes five illustrations. Simply select a number on the scale for the corresponding illustration and visual signs of severity. Select the Info button for symptoms, pathology, treatment options and more.

* The Efron Grading Scales are designed to help eye care practitioners. It is not a substitute for a professional consultation with a qualified eye care practitioner.

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