Application of an integral scoring of the anterior surface of the eye in corneal diseases

Background. Corneal diseases are a common cause of visual impairment, which requires timely diagnosis and objective assessment of its condition. The paper analyzes modern corneal staining scales and proposes a method of integral scoring. The me­thod allows to quantify the severity of symptoms, monitor the course of the disease and the effectiveness of therapy. Objective: to develop a modified integral corneal scoring scale by analyzing the methods of existing scoring scales and to evaluate its effectiveness in corneal diseases. Materials and methods. Two observation groups were selected for the evaluation. The first one consisted of patients after keratitis (acute phase), 20 eyes, the second group included people with chronic dystrophic corneal diseases (chronic phase), 18 eyes, and the control group — 20 eyes (second, healthy eye). Results. The study analyzed the nature of corneal neovascularization. In group I (acute inflammatory and traumatic conditions), superficial neovascularization was observed in 50 % of cases (6 eyes), deep one in 33 % (4 eyes), and mixed one in 17 % (2 eyes). In group II (patients with corneal dystrophies), deep vascularization prevailed in 46 % of cases (6 eyes), while superficial vascularization was observed in 30.7 % (4 eyes) and mixed vascularization in 23.1 % (3 eyes). These results confirm that superficial neovascularization is characteristic of acute processes, and deep neovascularization — of chronic degenerative changes. For the quantitative analysis of clinical signs, the method of integral scoring with symptom ranking was used. It was found that in group I the average integral index of symptom severity was 0.7, in group II — 0.2, and in the control group — 0.01. This indicates the presence of moderate or mild symptoms in dystrophies and its absence in healthy individuals. The proposed method of ranking allows us to objectively assess the severity of corneal lesions, their dynamics and the effectiveness of the treatment. Conclusions. An integrated approach to assessment allows not only to quantify clini­cal symptoms but also provides the ability to track the dynamics of the disease, identify trends in progression or regression, and evaluate the effectiveness of the therapy. This approach is recommended for use in both clinical practice and research.