Superior lacrimal punctum Inferior lacrimal punetuni Nasolacrimal duct turbinate Sipe ogee mule a aaa et Mai ctr maze Sioa ns mute Tal sea ‘saan hao Late ee male ‘etna Pete ‘ste Faia hath faba Tito eae‘orba part ofthe Supeior punctumlacrinake ‘berms ganNormal tarsal conjunctiva. The ‘olla line shows the area to be examined Normal Eyelid: The eyelids and comea are observed first fr inurned eyelashes ‘and any comeal opacity. The upper eyelids then turned over (everted) to ‘examine tha conjunctive over the stffer part ofthe upp i (tarsal conjunctive), ‘The nermal conjunctiva s pink, smooth, thn and transparent. Over the whole {area othe tarsal conjunctiva Bere are normally large deep-iying blood vessels that run vertcaly, ‘Trachomatous inflammation: ‘olicuiar TF} ‘Trachomatous inflammation - Follicular (TF): The presence of fue or more falicles inthe upper tarsal conjunctiva. Flicies are round swellings that are paler than the surrounding conjunctiva, appearing white, grey or yeliow, Follies ‘must be a least O Simm in clameter. “Trachomatous iflammation- {olicutar and intense (TF +’) ‘Trachomatous inflammation — Follicular and Intense (TF + TI: Pronounced Intlammatory thickening of ne tarsa! conjunctiva that obscures more than ha of the normal deep tarsal vessels. The tarsal cenjuncive appears red, cough and. thickened There are usually numerous folicles, wich may be parialy or totaly ‘covered bythe thickened conjunctiva, ‘Trachomatous Scarring (TS): The presence of scartng inthe tersal conjunctiva. Scars are easiy visible as wht ines, bands, or sheets in the tarsal conjunctiva, They are glistening and fitrous in appearance. Scarring, especially fuse fixosis, may obscure the tarsal bood vessels, ‘Trachomatous Trichiasis (TT): Atleast one eyelash rubs onthe eyeball Evidence of recent removal of ntured eyelashes should also be graded 2s tehasis ‘Cornea Opacity (CO) Corneal Opacity (CO): Easily visible comes opaciy over the pupil. The pupil ‘margin s blurred viewed through the opacty. Such corneal opacities cause ‘signcant visual imparment (ess than 6/18 oF 0.3 vison), ana therefore wsual ‘scuity should be messured if possible.