Related Experiment Video
Updated: Oct 29, 2025
Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
Published on: May 25, 2022
Tarsier Anterior Chamber Cell Grading: Improving the SUN Grading Scheme with a Visual Analog Scale
Marc D de Smet1, Daphne Haim-Langford2, Ron Neumann3
1MIOS Sa, Lausanne, Switzerland; Department of Ophthalmology, Leiden Medical Center, University of Leiden, Leiden, The Netherlands.
Purpose:
To compare an analog visual scale in grading anterior chamber cells (ACC) to a modified Standardization of Uveitis Nomenclature (SUN) ACC scale.
Method:
A graphical representation of anterior chamber cells as a reference and a test set was created and shown to two groups of experienced uveitis experts. Group 1 was given the analog scale in written format, while group two was given the reference images for comparison. Each test subject was asked to provide the best approximation for each grade.
Results:
Eleven graders participated in phase 1. Correct grading occurred in 87.4% of cases. Discrepancies were seen at all grades. Only 3 of 11 graders were able to achieve a perfect score. Seven graders participated in phase 2. Agreement was 95.2% with 4/7 graders achieving a perfect score. Discrepancies were seen at higher grades only.
Conclusions:
ACC grading is improved by a visual grading scale, and interobserver variability is reduced.
