Table 1 Fine grading scheme for clinical assessment of trachoma

Sign	Rating	Definition of rating
Follicles	0	No visible follicles in the upper tarsal conjunctiva.
	1	One or two small follicles in the upper tarsal conjunctiva.
	2	More than two but less than five follicles of 0.5 mm in diameter in the upper tarsal conjunctiva.
	3	The presence of five or more follicles in the upper tarsal conjunctiva. Follicles must be at least 0.5 mm in diameter (equivalent to WHO simplified grading of TF).
	4	Extensive large follicles of 0.5 mm in diameter.
Inflammation	0	No visible inflammation of the tarsal conjunctiva.
	1	Mild inflammation of the tarsal conjunctiva without obstruction of the vessels.
	2	Moderate inflammation of the tarsal conjunctiva with less than half of the deep tarsal vessels being obscured.
	3	Pronounced inflammatory thickening of the tarsal conjunctiva that obscures more than one-half of the normal deep tarsal vessels (equivalent to WHO simplified grading of TI).
	4	Very pronounced inflammation of the tarsal conjunctiva.
Scarring	0	No visible scarring in the tarsal conjunctiva.
	1	Small amount of early scarring apparent, but not clearly visible.
	2	Moderate amount of early scarring apparent, but not clearly visible.
	3	The presence of clearly visible scarring in the tarsal conjunctiva (equivalent to WHO simplified grading of TS).
	4	Extensive clearly visible scarring involving most of the tarsal conjunctiva.
Trichiasis	0	No visible trichiasis.
	3	At least one eyelash in contact with the eyeball, or evidence of recent removal of in-turned eyelashes (equivalent to WHO simplified grading of TT).

TF, trachomatous inflammation follicular; TI, trachomatous inflammation intense; TS, trachomatous scarring; TT, trichiasis; WHO, World Health Organization.