Assessing the severity of conjunctivochalasis in a senile population: a community-based epidemiology study in Shanghai, China

Table 1 Modified Meller and Tseng's grading system for conjunctivochalasis used in the present study*

	Basic grading criteria		Supplement grading criteria
	Folds versus Tear Meniscus Height(F)	Symptoms(S)	Punctual Occlusion and Tear Meniscus Height(O)	Height/extent of chalasis Changes in Downgaze(G)	BUT(B)
0	No persistent fold	No	Without occlusion	No difference	>= 10s
1	Single, small fold	No	Without occlusion and tear meniscus height <= 0.3 mm	No difference	>= 10s
2	Two or more folds and not higher than the tear meniscus	Mild	Nasal location with partial occlusion and irregular tear meniscus	mildly increases in downgaze	6-9s
3	Multiple folds and higher than the tear meniscus	Medium	Nasal location with complete occlusion and discontinuous tear meniscus	Significant increase in downgaze	4-5s
4	Multiple folds, higher than the tear meniscus, and causing exposure problems	Severe	Nasal location with complete occlusion and no tear meniscus	Severely increase in downgaze	<= 3s

*Symptoms indicate dryness, foreign body sensation, and epiphora, evaluated by the patients themselves BUT:break-up time(seconds)
This grading system for conjunctivochalasis obeys the following rule: if the clinical appearance of a certain patients corresponds to F2 + S2, or F2+ any two of O2, G2 and B2, the patient will be diagnosed as Grade II conjunctivochalasis, and so forth with Grade0, Grade I, Grade III, or Grade IV.
Grade II, Grade III, and Grade IV are also defined as "clinical significant conjunctivochalasis".

ISSN: 1471-2458