The purpose of the present study was to evaluate the change in visual acuity and refraction taking place in eyes with progressing early lens opacities. Four hundred and ten hypercholesterolemic men in Eastern Finland who participated in the Kuopio Atherosclerosis Prevention Study were followed up for 3 years. Lens opacities were graded using the lens opacity classification system II (LOCS II). The change of visual acuity and refractive error from baseline to a 36-month examination was compared for different types of lens opacities. During the 3-year period, progression in the LOCS II was observed in 9.2% of the eyes for nuclear, in 4.8% for cortical and in 0.5% of the eyes for posterior subcapsular opacities. Increasing nuclear sclerosis reduced visual acuity statistically significantly both with and without correction. Hypermetropization was seen to continue in eyes with no lens opacity progression. Myopization was more common in eyes with lens opacity progression, although this was not statistically significant.