A new computer assisted objective method for quantifying vascular changes of the bulbar conjunctivae

A novel computer software method was used to quantify the conjunctival plexus on the scleral background for measurement of the vascular surface area from photographs. A previously described method was used (Palmer, J. R., Owen, C. G., Ford, A. M., Jacobson, R. E. and Woodward, E. G. (1996). Optimal photographic imaging of the bulbar conjunctival vasculature. Ophthal. Physiol. Opt. 16, 144-149) to optimise photographic imaging of the bulbar conjuctival vasculature by increasing the information content in the image. Repeatability of this technique was evaluated. Twenty subjects (20 eyes) free from ophthalmological and systemic abnormality were examined on two separate occasions. The maximum 95% confidence limits for repeatability are +8.58/-3.95%. For 10 consecutive estimates of vascularity the maximum 95% confidence interval lie between +/- 6.54%. To evaluate the technique the lateral-bulbar conjunctivaein 10 soft (SCL) and 10 rigid gas permeable contact lens (RGPCL) wearers during the first 10 months of contact lens wear, were assessed and compared with subjective grading of hyperaemia. The new method showed sufficient sensitivity in detecting increased hyperaemia in the RGPCL wearing group and demonstrated statistically significant change. Subjective graded assessment of vascularity (using established classifications) detected increased hyperaemia, however, this was not statistically significant. Conjunctival vasculature is a dynamic structure and a source of valuable quantitative information where the ocular environment is varied, or where the ocular surface is affected by disease. Hence it is worthy of further investigation. A simple inexpensive method of computer assisted determination of vascularity is described.