Human lens nuclear colour matching and brunescence grading in vivo

The nuclear colour of in vivo human lenses has been investigated by means of a colour matching technique, using ‘Munsell’ colour samples. Observations covered an extended age range, and included all degrees of nuclear pigmentation. A positive correlation was noted between increasing nuclear pigmentation and age. The colour matching data generated was used as a basis for establishing a system of nuclear brunescence grading. The system of grading consists of a Grade 0 for absence of brunescence, and Grade 1 to Grade 5 for increasing brunescence. The ‘Munsell’ notation for samples representing these grades are: Grade 0 (5GY 6/1), Grade 1 (5Y 7/4), Grade 2 (2.5Y 7/8), Grade 3 (7.5YR 6/8), Grade 4 (5YR 4/6), and Grade 5 (2.5YR 2.5/2). Assessments of both inter- and intra-observer variability in the use of the derived scale have shown the new colour grading system to be reliable. The measure is simple to use during biomicroscopic slit-lamp examination of the lens, and has the potential for routine clinical application as well as for use in clinical trials where detailed documentation of lens morphology is required. The new colour scale may be used either as an isolated measure, or as part of a battery of lens measures in the Oxford Clinical Cataract Classification and Grading system.