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Cataract grading systems

a review of past and present

Gali, Helena E.; Sella, Ruti; Afshari, Natalie A.

Current Opinion in Ophthalmology: January 2019 - Volume 30 - Issue 1 - p 13–18
doi: 10.1097/ICU.0000000000000542

Purpose of review To provide a comprehensive summary of past cataract grading systems, how they have shaped current grading systems, and the developing technologies that are being used to assess and grade cataracts.

Recent findings This summary of cataract grading systems examines the development and limitations that existed in past grading systems and how they have shaped the grading systems of present time. The Lens Opacities Classification System III (LOCS III) system is currently used both clinically and for research purposes. Recent advancements in imaging technologies have allowed researchers to create automatic systems that can locate lens landmarks and provide cataract grading scores that correlate well with LOCS III clinical grades. Utilizing existing technologies, researchers demonstrate that fundus photography and optical coherence tomography can be used as cataract grading tools. Lastly, deep learning has proved to be a powerful tool that can provide objective and reproducible cataract grading scores.

Summary Cataract grading schemes have provided ophthalmologists with a way to communicate clinical findings and to compare new developments in diagnostic technologies. As technologies advance, cataract grading can become more objective and standardized, allowing for improved patient care.

Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, San Diego, California, USA

Correspondence to Natalie A. Afshari, MD, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Dr #0946, La Jolla, San Diego, CA 92093-0946, USA. Tel: +1 858 822 1569; fax: +1 858 822 1514; e-mail:

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