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FL)EI OFFICE ECY 7545 11rA,[)I'@C)14,V\'1 5 3 7 0 7 - 7 E,4 5
FINAL REPORT
. Rog er G. Perkins, PhD 3M Toxicology Services Building 220-2E-02 St. Paul, MN 55144-1000
HWI Number: 40200470
Study Title:
PCFA\PP/\LI
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PrimaryEye Irritation/Corrosion Study of T-5898 in Rabbits (OECD Guidelines)
Signed:
Steven-M- Glaza
Date
Study Di@ector
.Acute Toxicology
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HWI Number: 40200470 Sample: T-5898
Acute Toxicology Steven M. Glaza Study Director Manager Steven R. Sorenson Study Coordinator Patricia Padgham In-lifeSupervisor Rose M. Bridge Report Supervisor
Page 2
KEY PERSONNEL
Laboratory Animal Medicine Cindy J. Cary, DVM Diplomate, ACLAM Supervisor
CONTENTS Paqe
Key Personnel
2
Objective
3
Test Material
3
Test System
3
Procedures
4
Summary of Results
6
Discussion
10
References
10
Appendix - Raw Data
11
HWI Number: 40200470 Sample: T-5898
Page 3
OBJECTIVE
The objectiveof this studywas to assessthe relativelevel of irritation/ corrosion produced followinga single exposureof a test materialto one eye of albinorabbits.1
All proceduresused in this study are in compliancewith the Animal Welfare Act Regulations. In the opinion of the Sponsorand study director,the study did not unnecessarilyduplicateany previouswork.
TEST MATERIAL
Identification
The test materialwas identifiedas T-5898 and describedas a clear, lightyellow liquid.
Purity and Stability
The Sponsorassumesresponsibilityfor purity and stabilitydeterminations (includingundertest conditions).
Storage and Retention
The test material was stored at room temperature. Any unused test material will be returnedto the Sponsorafter issuanceof the final report according to Hazleton Wisconsin (HWI) Standard Operating Procedure (SOP).
Safety Precautions
The test material handling procedureswere accordingto HWI SOPs and policies.
TEST SYSTEM-
Test Animal Adult albino rabbitsof the Hra:(NZW)SPFstrainwere procuredfrom HRP, Inc. and maintainedat the Hazleton Wisconsin facility at 3802 Packers Avenue, Madison, Wisconsin. Animal husbandry and housing at HWI comply with standards outlined in the "Guidefor the Care and Use of LaboratoryAnimals".2 The animals were individuallyhoused in screen-bottomcages in temperature-and humidity-controlledquarters, provided access to water ad libitum and a measured amount of Laboratory Rabbit Diet HF #5326, PMI Feeds, Inc., and held for an acclimationperiodof at least 7 days. The feed is routinelyanalyzed by the manufacturerfor nutritionalcomponentsand environmentalcontaminants.
HWI Number: 40200470 Sample: T-5898
Page 4
Samples of the water are periodicallyanalyzedby HWI. There were no known contaminantsin the feed or water that would have interferedwith or affected the resultsof the study.
Three female acclimatedanimals, weighing from 2,628 to 2,722 g, were selected and maintainedduring the study in the same manner as for the acclimation period. If variationsfrom the requiredtemperatureand humidityconditions existed, they were documented and considered to have had no adverse effect on the study outcome. The animals'eyes were examined on the day before test material administrationusing sodium fluoresceindye procedures. Only those animalswith no sign of ocular injury or irritationwere used. Animals were identifiedby animal number and correspondingear tag.
Justificationfor Species Selection
Historically,the New Zealand White albino rabbit has been the animal of choice based on its large orbit and nonpigmentediris.
PROCEDURES.
Pre2arationof Test Material
The test materialwas administeredas received. The pH of the test material was determined to be 7.6.
Treatment
Each rabbit received0.1 mL of the undilutedtest material placed into the evertedlower lid of the right eye, with the left eye servingas the untreated control. The upper and lower lids were gently held togetherfor 1 second to prevent loss of material and then released. The eyes of the rabbits remained unflushed.
Reason for Route of Administration
Historically,the ocular route has been the route of choice based on the method of Draize.3
Observations
The treatedeyes were observedfor ocular irritationat 1, 24, 48, 72, and 96 hours and Days 7 and 14 after treatment. Irritationwas graded and scored accordingto the Draize technique. Sodium fluoresceinexaminationswere used to aid in revealingpossiblecorneal injury at 72 hours and Days 7 and 14.
HWI Number: 40200470 Sample: T-5898
Page 5
Animals were weighed just before test materialadministrationand at weekly intervalsthroughoutthe study.
Termination At terminationof the experimentalphase, all animalswere designatedto be euthanized and discarded.
StatisticalAnalyses No statisticalanalyseswere requiredby the protocol.
Location of Raw Data, Records, and Final Report The raw data, records,and a copy of the final reportwill be retainedin the archives of HWI in accordance with HWI SOP.
HWI Number: 40200470 Sample: T-5898
Page 6
SUMMARY OF RESULTS
Test Animal: Albino Rabbits - Hra:(NZW)SPF Source: HRP, Inc., Kalamazoo,MI Date Animals Received: 02/17/94
ExperimentalStart Date: 02/24/94 ExperimentalTerminationDate: 03/10/94
Average Primary Eye IrritationScores*
Observation Period
Average Score
1 Hour 24 Hour 48 Hour 72 Hour 96 Hour
Day 7 Day 14
24.3 26.7 15.0 10.3 7.3 4.3 0.0
The averageprimaryeye irritationscore*isthe total eye irritation score for all the animalsdivided by the number of animals (3) at each observationperiod.
HWI Number: 40200470 Sample: T-5898
Page 7
Animal Number
F49828u F49829t F49795u
Table I
IndividualEye IrritationStores
Cornea A
Iris c
Conjunctivae E
I Hour
1
1
11
2
2
2c
11
2b
3
2c
1 1
2
11
1
2b
2
2c
Mean
Total Score*
22.0 29.0 22.0 24.3
24 Hours
F49828 1 1 1111 22bb 32 2idc 2304..00
F49829
1
F49795
1
3 1
11
.2b
3
3c
26.0
Mean
26.7
F49828 F49829 F49795
0
0
ij
2
ij
1
48 Hours
0
1
11
2b
ii
2
0
0
2
2c
1
0
Mean
2.0 27.0 16.0
15.0
Cornea
A - Degree of opacity B - Area of involvement
Iris
C - Degree of iridal irritation
Conjunctivae
D - Redness E - Chemosis F - Discharge
Totalscore= (A x B x 5) + (C x 5) + [(D+ E + F) x 2].
b Blanching. c Clear discharge.
d Purulent discharge. i Injected. j Cornealepithelialpeeling. t No pain responseafter test materialinstillation. u Excessivepawingat the treatedeye after test materialinstillation.
HWI Number: 40200470 Sample: T-5898
Page 8
Animal Number
F49828 F49829 F49795
Table 1 (Continued)
IndividualEye IrritationScores
Cornea A
Iris c
Conjunctivae
D
E
72 Hours
0
0
1
1
ij
1
0
1
0
0
il
2b
1
ic
0
2
1
0
Mean
Total Score*
2.0
18.0
11.0 10.3
96 Hours
F49828
0
0
0
F49829
1
1
0
F49795
1
1
0
0
0
2
1
.2
1
0
0.0
0
11.0
0
11.0
Mean
7.3
F49828 F49829 F49795
0
0
0
0
ij
1
Cornea
A - Degree of opacity B - Area of involvement
Day 7
0
0
0
0
1
0
0
2
1
Mean
Iris
C - Degree of iridal irritation
Totalscore= (AxBx5) + (Cx5) + [(D+E+
b Blanching. c Clear discharge. i Injected. j Corneal epithelialpeeling.
F) x2].
0
0.0
0
2.0
0
11.0
4.3
Conian(z-tiv-ae
B - Redness E - Chemosis F - Discharge
HWI Number: 40200470 Sample: T-5898
Page 9
Animal Number
F49828 F49829 F49795
Table I (Continued)
IndividualEye IrritationScores
Cornea B
Iris c
Conjunctivae
D
E
Day 14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Mean
Total Score*
0.0 0.0 0.0 0.0
Cornea
A - Degree of opacity B - Area of involvement
Iris
C - Degree of iridal irritation
Total score= (A x B x 5) + (C x 5) + [(D+ E + F) x 2].
Conjunctivae
D - Redness E - Chemosis F - Discharge
Table-2 Sodium Fluorescein Examination
Animal
Observation Period
Number
Sex
Preinitiation 72 Hour
Dav 7
Day 14
F49828
F
NEG
NEG
NEG
NEG
F49829
F
NEG
NEG
NEG
NEG
F49795
F
NEG
POS (5%) POS(5%) NEG
NEG Negative stain retention. POS Positive stain retention(areaof cornea involved).
HWI Number: 40200470 Sample: T-5898
Page 10
DISCUSSION
The test material,T-5898,when evaluatedfor its primaryeye irritation potentialin rabbits,producedcornealand iridal involvementand moderate to severeconjunctivalirritation. All treatedeyes had returnedto a normal appearance by Day 14 after treatment.
REFERENCES
1. "Acute Eye Irritation/Corrosion," Organisation for Economic Cooperation and Development's Guidelines for Testing of Chemicals, Section 405 (adoptedMay 12, 1981).
2. NIH PublicationNo. 86-23 (revised1985).
3. Draize, J. H., "Eye Mucosa," In: Appraisa7 of the Safety of Chemicals in Foods, Drugs and Cosmetics - Dermal Toxicity, Association of Food and Drug Officialsof the U.S.,pp. 49-50 (1959).
HWI Number: 40200470 Sample: T-5898
APPENDIX Raw Data
Page 11
PERSONNEL SIGNATURE SHEET ACUTE TOXICOLOGY
HWI: LOQ@4@
Name Rose M. Bridge
Job Title Report Supervisor
Signature
Anthony Cass Cindy J. Cary, DVM
Lab Animal Technician Lab Animal Veterinarian
Crt i@.
LT
Donna J. Clemons, DVM, MS Lab Animal Veterinarian
John A. Disch
Lab Animal Caretaker
Charles W. Fritz
Lab Animal Technician 640 14
Kari Garfoot
Lab Animal Technician
Steven M. Glaza
Manager
Kevin Grossman
Lab Animal Caretaker
Jeff Hicks
Lab Animal Technician
Sharen L. Howery
Research Assistant
Wayne A. Madison
Supervisor
Doug McConnell
Lab Animal Technician
Eileen McConnell Bud McDonald Albert Oleson Patricia Padgham
Staff Assistant Study Coordinator Lab Animal Caretaker In-lifeSupervisor
e-@:"Y'
0 .1900
Steven R. Sorenson
Study Coordinator
Annette R. Turner
Staff Assistant
Tamra L. Walker
Staff Assistant
Lana M. Weeden
Staff Assistant
Initials
@-o@o
aye@@ r
(G2/10-06-93)
HWI No.: i4t-)2jODL12t) TEST KATERIAL ADNINISTRATION RECORD
Test Naterial: -t-- See L@S
Physical Description: r-A k:Agk2eL--JC--.,Wi-
pH Result: 7-to
with Corning pH Neter No.
pH was determined on: undiluted material / AA
U - Unable to determine pH due to ma
Storage conditionsof test material: P-CY:!)NA
05510 dilution of
n tiA %
tiAlivA
Approxircmoaaitt@elyyH5cmlm@nfno
Lotttee@ssttmmaa@tteerrii@aallinstillation2 dropsof 0.5%
Dprpr@pdOrDpoaXariraRc@aainneeHCI (ODDhhtthh@aaiinneeL@ot
I were placed on the corneal
surface of _
eye(s) of each rabbit.Tech.@
Group&g Dose:-Qj-mL/-&Iag (Ljg-mL equivalent) Time: From_Li.A%a_Toja.-Q2_
Unflushed
&JG Flushed: tjia secondsaftertest materialinstillationt,he test eye of each animal was flushedwith t@,IA ML of Iukewam tap water for b.)A seconds / minutes. Time: From__NIQL_To_&Ia._
Group _
Dos
_g (-_--pLequivalentT)ime:FroitL_To_
Unflushed
Flushed:
seconds after test mate
stillationt,he test
eye of each animal was flushedwith _
mL o
m tap
water for _
seconds / minutes. Time: From_
vlDoswaes administeredusing a 1-mL disposable syringe. &)a Dose was administeredusing a "A -AL glass syringe. &A Dose was weighed into and administeredusing a weighing paper. &)A,Dosewas placed directlyon the cornealsurfaceof the right eye. The eyelids
were releasedimediately without forced blinkingor manipulation. Dose was placed into the everted lower lid of the right eye. The upper and lower lids were gently held together for one second and then released. &),-Oqther: tJA
DosingTechnician/Date:4.rCrkc Time of 1-hour scores: is.6q
L 9-.14-94 Technician/Date:
cir 1 2-p-l-cly
NA Not applicable.DEjtry f-rror ac
(E8/12-09-92)
Final data review by/Date:
-0Y1-
HWI No.: BODYWEIGHT/ TRUTMENT EFFECTRECORD
Test Material:
Species/SourcSetrain/Location: Rabbit/Hra:(NZW)SPF/I\Al
Date AnimalsReceived: 2--1-) 12- -')-C-lCL5
Initiatedin Room Number: I
Animal Number
6roup
PL-APA? Pl@
qpo-g
Initial Pain Response
Sex
SF*
Following
Animal Body Weights (9)
Time:13:41
Dosing Initiation Day 7
Day 14
Day 21
c
? L,1,4'g @ (.aI*'
'g-@gg 2q go 7q 15LB,
Technician C)LC
Date
Used Isca.10
Sodium fluoresceinexamination.
NEG Negative. POS Positive. NA Not applicable.
V Vocalization. E Excessive pawing of treated eye. N None.
OL C-
kg2qfs,
OLC
1
csg,0w4-c-kv 926"
2.S -0@L4
On the day of treatment,all animals were weighed and appeared normal before test material administration.
Technician/Date: CLc /@2-94-9q
Survivinganimalswere designated for sacrificeand discard. Technician/Date:
-c-?@,L
(E2/12-09-92)
Final data review by/Date:
HWI No.:
PRIMARY EYE IRRITATION OBSERVATIONS
Test Material:
Group: LIA
Test eye: -li_qht
Observation Period:
Animal Number F44 P824B pf@Iq (4-7QS
Locationof Corneal Lesions
Cornea
Opacity Area
Iris
Redness Conjunctivae
Chemosis
3
Discharge 9 C-
9 C-
gc
Sodium Fluorescein exam ti A
riA
ti A
Technician: Date:
OLra-9,1-9 Li
Eye IrritationScore:
Calculated by/Date: Verified by/Date:
O.C -7,Y
KA Not applicable. A Petite hemorrhaging. B Blanching.
C Clear discharge. D Purulent discharge. E Hair loss aroundthe eye. F Possiblenecroticareas. G Unable to visualizedue to
severe conjunctivalswelling. H No reactionto light.
I Injected.
J Cornealepithelialpeeling. K Cornealepithelialpitting. L Corneal'edema. N Hypopyon. N Corneal neovascularization. P Pannus. R Unable to visualizedue to
severe corneal opacity.
S Granulationscar tissue. POS Positivestain retention.
NEG Negative stain retention.
(E3/07-15-92)
Final data review by/Date: -,7hz
HWI No.: L6=mq2c)
PRIMARY EYE IRRITATION OBSERVATIONS
Test Material:
Group: LIA
Test eye: __Rilht
Animal Number
observation Period:
iE@4 P82.8
Location of Corneal Lesions
Cornea
Opacity Area
Iris
Redness 2_f& Conjunctivae
Chemosis 2@-
D ischarge ic
oedi:u:mFluorescein exam, ti
2.P "I@6.
H 0".g"c
13 Ilia
Technician:
Date:
2- - 2-S -c@-4
Eye IrritationScore: 2-Lp.-i
Calculated by/Date: L-.,i 2--2.,5-ci4 Verifiedby/Date: ;9,V
NA Not applicable.
A Petite hemorrhaging. B Blanching.
C Clear discharge. D Purulent discharge. E Hair loss around the eye.
F Possiblenecroticareas. G Unable to visualizedue to
severe conjunctivalswelling. H No reactionto light. I Injected.
J Corneal epithelialpeeling. K Corneal epithelialpitting. L Corneal edema. N Hypopyon. N Corneal neovascularization. P Pannus. R Unable to visualizedue to
severe corneal opacity. S Granulationscar tissue.
POS Positivestain retention. NEG Negative stain retention.
(E3/07-15-92)
Final data review by/Date: ,7h4
HWI No.: qn2rY--@q-JC)
PRIMARYEYE IRRITATIONOBSERVATIONS
Test Material: Group: biA
Test eye: __Right
Animal Number
Observation Period:
F4
@ZZ A4,,,.e
Location of Corneal Lesions
Cornea Iris
Opacity Area 0
Redness Conjunctivae
Chemosis
Discharge
Sodium Fluorescein exam Alf
X z
Al-4
Technician: Date:
Eye IrritationScore:
Calculated by/Date: Verified by/Date:
,771 CLC 13-3-qq
NA Not applicable. A Petite hemorrhaging. B Blanching. C Clear discharge. D Purulent discharge. E Hair loss around the eye. F Possible necrotic areas.
G Unable to visualize due to severe conjunctival swelling.
H No reaction to light. I Injected.
J Corneal epithelial peeling. K Corneal-epithelialpitting. L Corneal edema. N Hypopyon. N Corneal neovascularization. P Pannus. R Unable to visualize due to
severe corneal opacity. S Granulation scar tissue.
POS Positive stain retention. NEG Negative stain retention.
(E3/07-15-92)
Final data review by/Date:
HWI No.: L4n?-rYNqa 0
PRIMRY EYE IRRITATIOONBSERVATIONS
Test Material: Group: LIA
F@p F@
Test eye: -Riqht
Animal Number
Observation Period: 1:::@A-4-.-P824B-
Locationof Corneal Lesions
Cornea
Opacity Area
Iris
Redness Conjunctivae
Chemosis
Discharge
Sodium Fluorescein exam,
Ile 0
Technician: Date:
'1-71
M Not applicable. A Petite hemorrhaging. B Blanching. C Clear discharge. D Purulent discharge. E Hair loss around the eye. F Possiblenecroticareas. G Unable to visualizedue to
severe conjunctivalswelling. H No reactionto light. I Injected.
Eye Irritation Score:
Calculated by/Date: Verified by/Date:
ZO.
.721 clir 3-3-q!i
J Cornealepithelialpeeling. K Cornealepithelialpitting. L Corneal edema. N Hypopyon. N Corneal neovascularization. P Pannus. R Unable to visualizedue to
severe corneal opacity. S Granulationscar tissue. POS Positivestain retention. NEG Negativestain retention.
(E3/07-15-92)
Final data review by/Date: iL--l
LQLL
HWI No.: qn2fy,@q2c)
PRIMRY EYE IRRITATIOONBSERVATIONS
Test Material: Group: biA
Test eye: --Ij-qht
Observation Period:
f.Ag
AnimalNumber iE@q
Location of
Corneal Lesions
Cornea
Opacity
Area
Iris
0
Redness Conjunctiva-e
n
Chemosis 0
Discharge e5
Sodium Fluoresceinexam AJA
0 2-1 0 I /-.Ai
. 2-1 e>
Technician: A(f--)
Date:
2-2 -a
Eye IrritatioSncore: -7..3
Calculatedby/Date: I/
2-.;;-SC)@i
Verifiedby/Date: m C' 1-;---39,1
NA Not applicable. A Petitehemorrhaging. B Blanching. C Clear discharge. D Purulentdischarge. E Hair loss aroundthe eye. F Possiblenecroticareas. G Unableto visualizedue to
severeconjunctivaslwelling. H No reactionto light. I Injected.
J Cornealepithelialpeeling. K Cornealepitheliaplitting. L Corneal edema. N Hypopyon. N Cornealneovascularization. P Pannus. R Unableto visualizedue to
severecornealopacity. S Granulationscartissue. POS Positivestainretention. NEG Negativestainretention.
(E3/07-15-92)
Final data reviewby/Date: cxc- 3 -11
HWI No.: qn2fy'@q- IC)
Test Material: Group: --LZA
PRIKARY EYE IRRITATION OBSERVATIONS
f@@q F@,
Test eye: __Ri_qht
Animal Number
Observation Period: nato
A2,B C)PJ2-q
Locationof Corneal Lesions
Cornea
Opacity Area
Iris
Redness 0 Conjunctivae
Chemosis 0
Discharge
Sodium Fluorescein exam
Technician: Date:
CLC !3-3-9q
-i s 11/0
0
1
0
N)f(-r pos/o-
Eye IrritationScore: 4.3
Calculated by/Date: Cie 3-3-9,f Verified by/Date: IL--aL,?@
KA Not applicable. A Petite hemorrhaging. B Blanching.
C Clear discharge. D Purulent discharge. E Hair lossaround the eye. F -Possiblenecroticareas. G Unable to visualizedue to
severe conjunctivalswelling. H No reactionto light. I Injected.
J Cornealepithelialpeeling. K Cornealepithelialpitting. L Corneal edema. N Hypopyon. N Corneal neovascularization. P Pannus. R Unable to visualizedue to
severe corneal opacity.
S Granulationscar tissue. POS Positivestain retention. NEG Negative stain retention.
(E3/07-15-92)
Final data review by/Date:
HWI No.: L-k)7-fY)q--M
PRIKARYEYE IRRITATIOONBSERVATIONS
Test Material: Group: bl4
Animal Number
Observation Period:
P4
tSaL4 14
Test eye: ___Ri$Lht
Location of Corneal Lesions
Cornea
(Doo(:@oo
Opacity
Area
Iris
6
Redness
0
0
Conjunctivae
Chemosis
0
Discharge
0
FSodim Fluoresceinexam
Technician: Date:
/L/ In -C
Eye IrritationScore: o.o
Calculated by/Date: Verified by/Date:
/C:Z) oc- 13-it-91(
NA Not applicable. A Petite hemorrhaging. B Blanching. C Clear discharge. D Purulent discharge. E Ha-irloss around the eye. F Possiblenecroticareas. G Unable to visualizedue to
severe conjunctivalswelling. H No reactionto light. I Injected.
J Corneal epithelialpeeling. K Corneal epithelialpitting. L Corneal edema.
N Hypopyon.
N Corneal neovascularization.
P Pannus. R Unable to visualizedue to
severe corneal opacity.
S Granulationscar tissue. POS Positivestain retention. NEG Negative stain retention.
(E3/07-15-92)
Final data review by/Date: ar_ 13 -11-91-f
HWI No.: 402-900q-70
SCALEFORSCORINGOMM LESIONS (DRAIZE TECHNIQLIE)
(1) Cornea
(A) Opacity- Degreeof density (areamost dense taken for reading) No opacity.........................................................0................. Scatteredor diffusearea.detailsof irisclearlyvisibl.e......................1.*........ Easilydiscernibletranslucentareas.detailsof iris slightlyobscured..............2.*....
Opalescentareas,no detailsof iris visible,size of pupil barelydiscernibl.e........3.*.. Opaque,iris invisibl.e................................................4.*................
(B) Area of Cornea Involved One-quarter(or less),.butnot zero........................................I............... Greaterthan one-quarter,but less than half.................................2.............. Greaterthan half, but less than three-quarter.s..............................3............ Greaterthaq three-quartersup to whole area.................................4.............
A x B x 5 Total Maximum - 80
(2)Iris
(A) Values Nonm I.............................................................................. 0 Folds above normal. congestion. swelling. circumcorneal Injection (any or all of
or combinationof any thereof)iris is stillreactingto light(sluggishreactionis positive).........................................................I.*................ No reactionto light,hemorrhage,gross destruction(anyor all of these).............2*....
Ax5
Total Maximum - 10
(3) ConJunctivae
(A) Redness (refersto palpebraland bulbarconjunctivaeexcludingcorneaand iris) Vessels normal.......................................................0 ................ Vessels definitelyinjectedabove normal....................................I.............. More diffuse,deeper crimsonred. individualvesselsnot easilydiscernibl.e ..........2.*... Diffusebeefy red....................................................3.*................
(8)Chemosis No swelling.........................................................0 ................ Any swellingabove normal (includesnictitatingmembrane)........................1......... Obviousswellingwith partialeversionof the lids.............................2.* .......... Swellingwith lidsabout half closed.......................................3.*.............. Swellingwith lidsabout half closed to completelyclosed........................4.*........
(C) Discharge No discharge........................................................0................. Any amount differentfrom normal (doesnot includesmall amounts observed in inner canthus of normal animals)..............................................I................. Dischargewith moisteningof the lidsand hairs Just adjacentto the lids.............2.... Dischargewith moisteningof the lids and hairs, and considerablearea around the eye....3.
Score (A + B + C) x 2 Total Maximum - 20
The totalscore for the eye is the sum of all scoresobtainedfor the cornea,iris.and conjunctivae.
Indicatesa positiveeffect. (FHSAInterpretation)
(E4/01-06-91)