• Cornea
• Child health (paediatrics)
• Eye Lids
• Conjunctiva

Why are disease activity grading classifications helpful? And is allergic eye disease an example of a disorder for which this is the case? Chandrasekar and colleagues propose a grading system for the chronic bilateral allergic ocular inflammatory disease vernal keratoconjunctivitis (VKC)1 and its corresponding management. Grading classification systems are important for standardising assessment, communicating the severity of disease during longitudinal follow-up assessments, guiding treatment and for research purposes when analysing study patient populations. VKC is a chronic, recurrent disorder presenting as a spectrum of disease from mild to severe, with distinct clinical features that correlate with inflammation activity. These characteristics make VKC particularly suitable for a grade classification.

A number of previously proposed grading classifications reviewed by Chandrasekar and co-authors each have their merits and limitations. It is noteworthy that none have become widely used in clinical practice. Spadavecchia et al proposed a grading system based on symptoms and examination signs, scored from 0 to >2, with a sum …