According to the Standardization of Uveitis Nomenclature (SUN) Working Group scheme for grading anterior chamber cells, a hypopyon corresponds to which maximum grade?

• A Grade 1+ (101 to 200 cells)
• B Grade 3+ (301 to 500 cells)
• C Hypopyon is excluded from the cellular grading scale
• D Grade 4+ (more than 500 cells) ✓

Explanation

The SUN grading system counts cells in a 1 by 1 mm slit beam and grades them from 0 through 4+, where grade 4+ represents more than 500 cells. Hypopyon, being a layered collection of far more than 500 cells, is formally recorded as grade 4+ cells in this scheme. Grade 1+ covers 101 to 200 cells, grade 3+ covers 301 to 500 cells, and flare is graded separately on its own 0 to 4+ scale based on visibility of iris and lens detail.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

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