PubMed · 7239810
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C Scott, W Gleason. 1981. Photodocumentation.. https://pubmed.ncbi.nlm.nih.gov/7239810/
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Grading scales have been developed to assist practitioners in recording the level of severity of ocular complications of contact lens wear. Eight common complications are depicted in five levels of severity--from grade 0 (normal) to grade 4 (severe). The intersubject variance in grading was determined to be 1.0 scale units, which by coincidence concurs exactly with the key design strategy of the grading scales that each grading step of 1.0 corresponds to a clinically significant difference in severity.
BACKGROUND: Some months ago we described morphological changes in the stroma of the cornea of patients with a history of long term contact lens wear. These degenerations consist of little highly reflective structures called "micro-dots". For a more precise quantification of the micro-dots we established a clinically practicable method for measuring and counting. MATERIAL AND METHODS: The micro-dots can be visualized in optical sections with the scanning slit confocal microscope. To get the real thickness of a single optical section we had to develop a in vitro model, which consists of a gel of agar with particles of latex of different size. RESULTS: Some stereological methods made it possible to calculate the thickness of an optical section as seen with the confocal microscope. We found out that the thickness shows a variation depending on the reflectivity and size of the particles as well as on the aperture of the objective used. From the area of the frame and the thickness of the optical section we could calculate the density of the highly reflective particles. DISCUSSION: Up to now we could determine the morphological changes (micro-dots) in the cornea of patients with a history of long term contact lens wear in a semiquantitative manner only. With the presented method we are able to make a quite precise numerical estimation of micro-dots. This is very useful to follow up the progress of these stromal changes over many years.
Two new lens holders for contact lens use in vitreoretinal surgery were developed: (1) a flexible hand-fixed lens holder and (2) a lid-retractor-fixed lens holder. Advantages are: better stabilization and centering of the lens, reduction of air bubbles and blood in the interface between cornea and contact lens.