Objective measurement of allergic reactions in the eye

Conjunctival allergen challenge has become a useful model of human ocular allergy and an accepted method for studying the effects of topical antiinflammatory medications. Conjunctival allergen challenge reactions are typically evaluated in a subjective fashion. Erythema and edema are graded by observation, using a 0 to 4 scale. Itching is graded on a 0 to 4 scale by questioning the subject. We have reviewed the recent literature on conjunctival allergen challenge, including recently developed methods aimed at objective assessment of ocular allergic reactions, such as the erythema, edema, sensation, or EES, method.

Conjunctival erythema can be measured objectively using a spectroradiometer, or colorimeter, a device which measures the chromaticity of reflected light, and provides the x, or u', and y, or v', coordinates of any color. Edema of the eyelids and conjunctiva can be measured using a fractional millimeter reticule in the eyepiece of a slit lamp microscope. Ocular surface sensation can be evaluated using the aesthesiometer of Cochet and Bonnet, or by using a 'sensation index', a measurement that takes into account the intensity and duration of itching.

CAC reactions can be measured objectively using the erythema, edema, sensation method, as well as subjectively by observation and questioning.