Validation of Computerized Quantification of Ocular Redness

Ekaterina Sirazitdinova, Marlies Gijs, Christian J. F. Bertens, Tos T. J. M. Berendschot, Rudy M. M. A. Nuijts, Thomas M. Deserno*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)


Purpose: To show feasibility of computerized techniques for ocular redness quantification in clinical studies, and to propose an automatic, objective method.

Methods: Software for quantification of redness of the bulbar conjunctiva was developed. It provides an interface for manual and automatic sclera segmentation along with automated alignment of region of interest to enable estimation of changes in redness. The software also includes the redness scoring methods: (1) contrast-limited adaptive histogram equalization (CLAHE) in red-green-blue (RGB) color model, (2) product of saturation and hue in hue-saturation-value (HSV), and (3) average of angular sections in HSV. Our validation pipeline compares the scoring outcomes from the perspectives of segmentation reliability, segmentation precision, segmentation automation, and the choice of redness scoring methods.

Results: Ninety-two photographs of eyes before and after provoked redness were evaluated. Redness in manually segmented images was significantly different within human observers (interobserver, P = 0.04) and two scoring sessions (intraobserver, P

Conclusions: Computation of ocular redness depends heavily on sclera segmentation. Manual segmentation appears to be subjective, resulting in systematic errors in intraobserver and interobserver settings. At the same time, automatic segmentation seems to be consistent. The scoring methods relying on HSV color space appeared to be more consistent.

Original languageEnglish
Article number31
Number of pages13
JournalTranslational Vision Science & Technology
Issue number6
Publication statusPublished - Nov 2019


  • ocular redness
  • conjunctival
  • provocation test
  • allergy
  • image processing
  • clinical trials
  • clinical grading
  • sclera segmentation
  • EYE

Cite this