Moorfield blen grading
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Moorfields Bleb Grading System MBGS grading table central area maximal area height vascularity
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https://pmc.ncbi.nlm.nih.gov/articles/PMC6812775
Moorfields Bleb Grading System (MBGS) is a slit-lamp, photograph-referenced system for describing a filtering bleb after trabeculectomy.
| Parameter | Grades |
|---|---|
| 1a. Central bleb area | Area over the scleral flap, scored 1 to 5: approximately 0%, 25%, 50%, 75%, 100% |
| 1b. Maximal bleb area | Total visible bleb area, scored 1 to 5 using the same approximate percentage scale |
| 2. Bleb height | 1 flat, 2 low, 3 moderately elevated, 4 high/maximally elevated |
| 3a. Central vascularity | 1 avascular to 5 severe vascularity |
| 3b. Peripheral vascularity | 1 avascular to 5 severe vascularity |
| 3c. Non-bleb vascularity | Vascularity of adjacent conjunctiva, 1 avascular to 5 severe |
| Additional observations | Subconjunctival hemorrhage and Seidel test for leakage can also be recorded. |
Interpretation
- A diffuse, relatively avascular, low-to-moderately elevated bleb is often associated with good filtration.
- Increasing vascularity, especially in the central bleb, can suggest active wound healing and a higher risk of fibrosis or bleb failure.
- A flat, localized, or highly vascular bleb requires correlation with intraocular pressure, bleb function, timing after surgery, and clinical examination. MBGS describes morphology and does not by itself determine surgical success.
MBGS evaluates the bleb’s area, height, and vascularity using reference photographs; it is commonly used for postoperative follow-up and research comparison. MBGS clinical description
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