As trachoma prevalence declines worldwide, performing field surveys with trained trachoma graders to validate its elimination becomes challenging. Graded conjunctival images could be used to train graders, validate field grades, and replace field grading. We review the use of photography to capture conjunctival images for the detection of trachomatous inflammation-follicular (TF) and -intense (TI), Trachomatous trichiasis (TT), and eyelid contour abnormalities. Literature searches were conducted between October 29, 2020 and February 15, 2021. We abstracted kappa scores for agreement between field and image graders, between field graders, and between image graders. The median kappa was calculated for studies discussing grading for TF and TI. Twenty-one studies were included - 19 described the use of imaging tools for grading TF and TI; 1 discussed TT; and 1 discussed eyelid contour abnormalities. For agreement between field and image graders, median kappa for TF was 0.71 (range: 0.57–0.92) and TI was 0.67 (0.37–0.74); between image graders, median kappa for TF was 0.65 (0.37–0.78) and TI was 0.76 (0.39–0.83); and between field graders, median kappa for TF was 0.86 (0.73–1) and TI was 0.82 (0.73–0.91). There is potential for the use of photography for trachoma prevalence surveys. Further research is warranted, particularly for TT and using newer smartphones.

随着全球沙眼患病率的下降，与训练有素的沙眼分级员进行实地调查以验证其消除变得具有挑战性。分级结膜图像可用于培训分级员、验证现场分级和替代现场分级。我们回顾了使用摄影捕获结膜图像以检测沙眼性炎症滤泡 (TF) 和强烈 (TI)、沙眼性倒睫(TT) 和眼睑轮廓异常。文献检索于 2020 年 10 月 29 日至 2021 年 2 月 15 日期间进行。我们提取了现场评分员与影像评分员之间、现场评分员之间以及影像评分员之间的一致性 kappa 分数。为讨论 TF 和 TI 分级的研究计算了中值 kappa。纳入了 21 项研究——19 项描述了使用成像工具对 TF 和 TI 进行分级；1个讨论TT；和 1 讨论了眼睑轮廓异常。对于现场和影像分级员之间的一致性，TF 的中值 kappa 为 0.71（范围：0.57 – 0.92），TI 为 0.67（0.37 – 0.74）；在图像分级机之间，TF 的中值 kappa 为 0.65 (0.37 – 0.78)，TI 为 0.76 (0.39 –0.83); 在现场评分者之间，TF 的中位 kappa 为 0.86 (0.73 – 1)，TI 为 0.82 (0.73–0.91)。摄影有可能用于沙眼患病率调查。有必要进行进一步的研究，特别是对于 TT 和使用更新的智能手机。