Optometry Research Today is a free monthly online journal that collates and summarizes the latest research about Optometry, including details on myopia, optometric practice, therapy.

Limbal and bulbar hyperaemia in normal eyes.

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

Cardiff University, School of Optometry and Vision Sciences, Maindy Road, Cathays, Cardiff CF24 4LU, UK.

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.

Published 18 January 2008 in Ophthalmic Physiol Opt, 28(1): 13-20.
Full-text of this article is available online (may require subscription).

© 2005-2008 Optometry Research Today. All Rights Reserved.