Cataract grading systems: a review of past and present.

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.