According to Roper Hall classification, which grade of chemical eye injury is characterized by corneal haze with iris details still visible and conjunctival blanching less than one-third of the bulbar surface?

Explanation

## Roper Hall Classification of Chemical Eye Injuries **Key Point:** The Roper Hall classification is the standard grading system for chemical eye injuries, used to predict prognosis and guide management. Grade II represents mild-to-moderate injury with corneal haze and limited conjunctival involvement. ### Roper Hall Grading System | Grade | Corneal Clarity | Iris Details | Conjunctival Blanching | Prognosis | | --- | --- | --- | --- | --- | | **I** | Clear | Clearly visible | None | Excellent | | **II** | Haze (iris visible) | Visible | <1/3 of bulbar surface | Good | | **III** | Haze (iris blurred) | Blurred/obscured | 1/3–1/2 of bulbar surface | Fair | | **IV** | Opaque (iris not visible) | Not visible | >1/2 of bulbar surface | Poor | ### Grade II Characteristics 1. **Corneal involvement:** Haze visible but iris details still discernible 2. **Conjunctival involvement:** Blanching of <1/3 of bulbar conjunctiva 3. **Eyelid involvement:** Minimal or absent 4. **Anterior chamber:** Usually clear 5. **Prognosis:** Generally good with appropriate management **High-Yield:** Grade II and III injuries are the most common presentations in emergency departments. Grade IV injuries have poor visual prognosis and often require penetrating keratoplasty. **Clinical Pearl:** The presence of conjunctival blanching indicates ischemia from vascular injury; extensive blanching (Grades III–IV) suggests severe injury with higher risk of symblepharon and ocular surface failure. **Mnemonic:** **CHIC** for Grade II — **C**orneal haze, **H**aze with iris visible, **I**ris details visible, **C**onjunctival blanching <1/3.