Dr. Chylack has developed web-interactive and web-self-administered certification/re-certification training programs that physicians, optometrists, and occasionally Ph.D.s can use to train in the application of the LOCS system. These programs have been widely used by pharmaceutical companies under license agreements with the Brigham and Women's Hospital (BWH) and more recently with Chylack Inc.  A fully-executed License Agreement between a user/sponsor and Chylack Inc. is needed to initiate a LOCS III Training Program.

If you wish to pursue LOCS training for yourself, or on behalf of a clinical study, please contact us to initiate a license agreement.

Training as part of a sponsored study

Training as part of a sponsored study?

Training for a group of protocol participants, or “Authorized Users“ is conducted with a LOCS License executed by the Sponsor and customized according to the number of Users enrolled over the term of the protocol. Once a User has been certified, the re-certification interval is every six months for as long as the User is enrolled. For more information about LOCS training for a clinical study, please contact our office.

Training as an individual

Training as an Individual

Training as an individual is only rarely the method used to secure LOCS training; more commonly the eye specialist is under contract with a pharmaceutical company or institution, and the training is secured under a license granted to that company or institution.
      However, training for individuals can be conducted with a LOCS License customized to the individual’s level of experience with LOCS. The costs of such training, certification, and re-certification are borne by the individual.

What is the format of the training?

What is included in the training program?

The web-based LOCS III self-administered training programs consist of several recorded sessions. In total, the recordings are approximately 4-5 hours long.  Trainees may view the recordings in a single session or may choose to view them in a series of sessions.  The individual sessions are available "24/7" with passwords obtained from Chylack Incorporated.  A course of web-based training includes the following recorded sessions:  

The LOCS III WebEx Recording-Introduction
A nine-minute recording that introduces the user to the WebEx Recorded Session and the WebEx Player - the program the user will use to control the pace of the session. This Recorded Session is unnumbered. The user must take this session before accessing the other sessions.

An 18-minute recorded session that teaches the user how to identify artefacts present in Neitz-CTR retroillumination images. All LOCS III web-training and web-testing recordings use these images, so it is very important that the user know how to recognize these artefacts.

The LOCS III Self-Administered Training (Part 1)
This session introduces the user to the LOCS III grading system.

The LOCS III Self-Administered Training (Part 2)
This is a practice-grading session for cortical and posterior subcapsular cataract.

The LOCS III Self-Administered Training (Part 3)
This is a practice-grading session for nuclear cataract and nuclear color.

The LOCS III Self-Administered Certification Test (Part 4)
This session contains a brief review of LOCS III and a formal test of competence. It should not be taken until the user has completed the five sessions listed above.

History of LOCS training

Training in use of LOCS II or LOCS III has been available since the early 1990s. It was not long after the introduction of face-to-face training programs that pharmaceutical companies requested testing to assess the competency of individuals who completed the training. Testing was first conducted in face-to-face sessions with slit and retro images illustrating various types and degrees of severity of nuclear cataract, nuclear color, cortical and posterior subcapsular opacification. Eye-care specialists passing these competency tests were issued a certificate attesting to the fact that the individual had taken and passed a formal test of competence in LOCS III grading.
    Quickly, the number of individuals seeking LOCS II or III training and certification increased, thus requiring the training and testing to shift to a web-based and self-administered format. This was accomplished with the help of Webex and was run for years as a service provided through licenses with the Brigham and Women’s Hospital in Boston, MA.
    As the length of pharmaceutical studies increased, and as the focus often became the impact of drug administration on the rate of progression of lens opacification, it was necessary to implement a method by which doctors could be re-certified as LOCS III graders in longitudinal studies. This was accomplished via Webex-based recordings and re-certification tests. These Certification and Re-certification sessions are now offered through licenses with CI.

Upon completing the LOCS training, each student is required to take and pass a test of competence (e.g., "LOCS III Self-Administered Training (Part 4) – Certification Test"). This Certification test assesses the student’s ability to grade lens opacification and nuclear color in sets of photo-images. These tests are offered via and are available 24/7/365.

    Tests found on the site are labeled "Certification Test" or "Re-certification Test 01", "Re-certification Test 02", etc..  Authorized Users should confirm with their sponsor which test they are scheduled for BEFORE they begin.
    Blank answer sheets are provided by the sponsor.

    Once a student has completed their test and submitted their answer sheet, their answers are graded. The lowest passing grade is a 70%. Dr. Chylack evaluates each test answer sheet and writes a note to the student indicating where there are any problems, if any, and which additional material must be reviewed to correct them. If the student passes the test, a final test score is assigned and an email documenting the doctor’s certification status is sent to the sponsor. At that point, they are certified to begin grading using LOCS.
    If a student fails a test, a note is written which instructs the student to review specific recordings before re-taking the same web-based test. If the student fails the test twice, Dr. Chylack (with the approval of the sponsor), will set up a web-interactive training and grading session for the student. At the end of this review, Dr. Chylack will instruct the student to retake the re-certification test. If the student fails this test, usually no further training or testing is indicated and the student is withdrawn from the study by the sponsor.
    At the beginning of each Re-certification Test there is a brief review of the rules of LOCS  grading. The completed test answer sheet is triple-graded by Chylack Inc. The individual test scores from each grader are reconciled and then a final test score is assigned and an email documenting the doctor’s certification status is sent to the sponsor. The test must receive a passing grade for that grader to continue using LOCS.
Webex interface
WebEx Technical Support Line: 
1 - 866-229-3239
Available Languages:
All training and instruction materials are in English. Translations of the basic written instructions are available in the following languages:
  • Brazilian,
  • Bulgarian,
  • Croatian,
  • Czech Republic,
  • Danish,
  • Dutch,
  • Finnish,
  • French,
  • German,
  • Hungarian,
  • Italian,
  • Japanese,
  • Korean,
  • Ukrainian,
  • Polish,
  • Portuguese,
  • Romanian,
  • Russian,
  • Slovakian,
  • Slovenian,
  • Spanish,
  • Swedish,
  • Thai,
  • Turkish.