A simplified cataract grading system.

A simplified method for grading the presence and severity of different cataract types is needed for field use in assessment of the magnitude of the cataract problem. A cataract grading system was developed by a panel of experts with the objective of making available a simple system for use with a slit lamp to allow for the reliable grading of the most common forms of cataract by relatively inexperienced observers. Three levels, reflecting progressive severity, for grading of nuclear, cortical and posterior subcapsular (PSC) cataract were included in the classification; three standard photos were used for grading nuclear cataract. Field evaluation from four different sites indicated very good to fair interobserver agreement with the use of this system following minimal training of residents in ophthalmology at each site. Further testing of this system is warranted. The WHO simplified cataract grading system should allow for the obtaining of comparable data across countries based on field assessment of the most common forms of cataract.