| Lid Debris (collarettes, clumps/strands) – upper and lower eyelids |
| (0) Normal: Clear eyelid margin |
(1) Mild: Occasional fragment, 1-5 collarettes |
| (2) Moderate: Few fragments, 6-20 collarettes |
| (3) Severe: Many fragments, 21-40 collarettes |
| (4) Very severe: Clumps/strands, >40 collarettes |
| Eyelid Margin Erythema (lower eyelid) |
| (0) Normal: Normal age-related redness and vasculature. |
| (1) Mild: Slightly dilated blood vessels; vessels colored pink; present in the middle 2/3 section
of the lower eyelid margin. |
| (2) Moderate: More apparent dilation of blood vessels; vessel color more intense, whole margin of
the eyelid is involved. |
| (3) Severe: Increased vascularity of the eyelid margin, numerous and obvious dilated blood
vessels, deep red in color, whole margin of the eyelid is involved. |
| (4) Very severe: Clearly increased confluent vascularity of the eyelid margin; large, numerous dilated
blood vessels characterized by deep red color, whole margin of the eyelid is involved. |
| Plugging of the Meibomian Gland (in the middle part of lower lid, n=10) |
| (0) Normal: Clear orifices of meibomian glands in the middle part of lower lid (n=0) |
| (1) Mild: Less than 1/3 of orifices but at least one contain turbid secretions (n=1-3) |
| (2) Moderate: Between 1/3 and 2/3 of orifices contain turbid secretions (n=4-6) |
| (3) Severe: More than 2/3 of orifices but not all contain turbid secretions (n=7-9) |
| (4) Very severe: All orifices plugged with turbid or coagulated secretions (n=10) |
| Secretion Expressed from the Meibomian Gland (lower eyelid) |
| (0) Normal: Minimal clear, oily secretion |
| (1) Mild: Cloudy secretion |
| (2) Moderate: Granular secretion |
| (3) Severe: Paste-like secretion |
| (4) Obstructed: No expressible secretion |