Migdal and Hitchings developed a grading scale for the gross appearance of a glaucoma drainage bleb. This can be used to monitor the patient after surgery. The authors are from Moorfields Eye Hospital in London.
Appearance
Grade
absent change (not elevated, no engorged)
I
elevated, engorged conjunctiva
II
elevated, engorged conjunctiva, pale area
III
engorged conjunctiva around suture line
IV
elevated, pale
V
elevated, cystic
VI
The change in the bleb can help identify patients who have a successful surgery.
A low bleb score correlates with inflammatory changes and poor bleb function.
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