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July 1989

Lens Opacities Classification System II (LOCS II)

Author Affiliations

From the Center for Clinical Cataract Research (Drs Chylack, Khu, and Kashiwagi and Mr McCarthy), the Brigham and Women's Hospital (Drs Chylack, Khu, and Kashiwagi), the Massachusetts Eye and Ear Infirmary (Drs Chylack, Khu, and Kashiwagi and Mr McCarthy), and the Department of Ophthalmology, Harvard Medical School (Drs Chylack, Khu, and Kashiwagi), Boston; the Division of Epidemiology, Department of Community and Preventive Medicine, State University of New York at Stony Brook (Dr Leske); and the Biochemistry and Epidemiology Program, the National Eye Institute, Bethesda, Md (Dr Sperduto).

Arch Ophthalmol. 1989;107(7):991-997. doi:10.1001/archopht.1989.01070020053028

• The Lens Opacities Classification System, version II (LOCS II), uses a set of colored slit-lamp and retroillumination transparencies to grade different degrees of nuclear, cortical, and subcapsular cataract. The system uses four nuclear standards for grading nuclear opalescence and color, five cortical standards, and four subcapsular standards. The LOCS II can be used to grade patients' cataracts at the slit lamp or to grade slit-lamp and retroillumination photographs; it is easy to learn and can be applied consistently by different observers. We obtained very good interobserver reproducibility of the clinical gradings at the slit lamp, excellent intraobserver reproducibility, very good to excellent interobserver reproducibility of photographic gradings, and good agreement between clinical and photographic gradings. The LOCS II is potentially useful for both cross-sectional and longitudinal studies of cataract.

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