THE ANATOMY & PHYSIOLOGY

OF LENS

Dr Prabhjot Singh
 REFERENCES
Anatomy & Physiology of eye – A.K.Khurana
Parsons’ Diseases Of The Eye- 23rd Edition
American Academy of Ophthalmology 2020-2021
 INTRODUCTION
The ancient Greeks and Romans believed that the lens was the part of the eye
responsible for the faculty of seeing. They theorized that the optic nerves were
hollow channels through which “Visual spirits” traveled from the brain to meet
visual rays from the outside world at the lens, which they thought was located in
the center of the globe. The visual information would then flow back to the brain.
This concept was known as the emanation theory of vision.
The true position of the crystalline lens was illustrated by the Italian anatomist
Fabricius in 1600
 FUNCTIONS OF LENS
Maintenance of transparency

Refraction

Accommodation

Protection from U-V rays

 ANATOMY OF LENS

Transparent, biconvex, crystallin

structure

Lies between post surface of iris & the

vitreous in a saucer shaped depression-
patellar fossa.

Asymmetrical Oblate Spheroid

Post surface of lens is in contact
with vitreous & attached to it in a
circular area with Wiegert's
ligament aka Ligament
Hyaloideo-capsulare

There is a potential space

between post lens capsule &
Wiegert's ligament c/a Berger's
space.
 DIMENSIONS OF LENS
Equatorial diameter of lens in adult is 9-10mm

Axial diameter/AP diameter/Thickness- at birth about 3.5mm

Adults- 4.75-5mm
 SURFACES OF LENS
Two Surfaces

The ant. Surface is less convex -radius of 10mm (8

to 14mm).

The post surface is more convex -radius of 6mm

(4.5 to 7.5 mm).

The two surfaces meet at the equator. Equator is

almost circular and has rippled/ undulated
appearance.
POLES
POLES
Anterior Pole - centre of ant surface
OF LENS

- 3mm from the back of cornea.

Post pole lies in centre of post surface.
REFRACTIVE INDEX
1.39 (Cortex - 1.386 , Nucleus-1.426)
REFRACTIVE POWER

About 16 - 17 D.
ACCOMODATIVE POWER :- varies with age

At Birth 14 to 16 D

At 25 years - 7 to 8 D

At 50 years - 1 to 2 D

COLOUR :- varies with age:- Colourless in infant & young adult

Yellow tinge after 30 years

Amber coloured in old age

CONSISTENCY:- Cortex softer than nucleus

 STRUCTURE OF LENS
Crystalline structure

Avascular

Devoid of nerves and connective tissue

Three distinct parts- Capsule

Ant Lens Epithelium

Lens Substance/Lens Fibres

 THE LENS CAPSULE
Membrane like structure surrounds the lens completely.
Highly elastic but does not contain any elastic tissue.
Secreted by basal cell area of Lens epithelium ant and by basal area of the
elongated fibres post,
Thickest basement membrane of body.
Ultramicroscopic exam shows lamellar appearance- each lamella contains fine
filaments.
Composed of type IV collagen.
THICKNESS
OF CAPSULE
Thicker anteriorly than post

Thicker at equators than poles

Thinnest at Post equator

 THICKNESS
OF CAPSULE

Thicker anteriorly than post

Thicker at equators than poles

Thinnest at Post equator

 CLINICAL SIGNIFICANCE
True Exfoliation
Superficial zonular lamella of the capsule
splits off from the deeper layer - tends to
scroll up on itself
Exposure to infrared radiation
PsedoExfoliation
Basement-membrane like fibrillo-granular
white material deposited on the lens capsule,
cornea, iris, anterior hyaloid face, ciliary
processes, zonular fibers and trabecular
meshwork.
Age related micro-fibrillopathy.
Vossius Ring
Imprinted iris pigments in the
anterior surface of anterior lens
capsule due to blunt trauma to eye

Radiation Induced Cataract

Punctate opacities within posterior
lens capsule Voissius ring

Feathery anterior sub capsular

opacities radiating towards the
equator

Ionizing radiation
induced catarct
ANTERIOR LENS EPITHELIUM
Single layer of cuboidal nucleated epithelial cells

lies deep to ant capsule.

Responsible for all metabolic, synthetic & transport processes of lens

In the equatorial region, these cells become columnar, are actively dividing
& elongating to form new lens fibres throughout life.

There is no post epithelium as these cells are used up in filling the central
cavity of lens vesicle during development of lens.
 ZONES OF LENS EPITHELIUM
(A) Central Zone :
Cuboidal cells
number reduces with age
Normally do not mitose
may mitose in injurious insults like uveitis
During injury repair- elongated; resemble fibroblasts ,can pile up to 10 layers
thick
Metaplasia into myofibroblast like cells- anterior subcapsular cataract (like
shield cataract) and glaukomflecken (attack of acute congestive close angle
glaucoma)
 ANTERIOR SUBCAPSULAR
CATARACT - SHIELD CATARACT
GLAUKOMFLECKEN
(B) Intermediate Zone:
Smaller & more cylindrial cells located peripheral to central zone.
Mitose occassionally
(C) Germinative Zone :
Most peripheral columnar cells
Actively dividing , migrate post to form lens fibres.
Extremely susceptible to irradiation
Dysplasia of this transitional zone may cause post subcap-cat (e.g.-Radiation cat,
myotonic dystrophy & Neurofibromatosis II)
 POSTERIOR CAPSULAR
OPACIFICATION (PCO)
Radiation Cataract,
NF II
Myotonic dystrophy
 FEATURES OF LENS EPITHELIUM

Ant lens epi has the highest metabolic rate

Lens epithelial cells have a prominent cytoskeletal network consisting of actin

The lateral membrane of the epithelial cells lacks tight/occluding junctions.

Apical membrane of the lens epithelial cells interfaces with the apical membrane
of elongating fibre cells as they migrate. The unique apico-apical interface is
known as epithelial fibre cell interface (EFI).

The EFI plays a key role in the lens physiology.

 LENS FIBERS
Primary lens fibers are formed from
posterior epithelium during embryogenesis

Secondary fibers are formed constantly

throughout life by elongation of lens epithelium
at equator from germinative cells

As the lens fibers are formed throughout life,

these are arranged compactly as Nucleus &
Cortex of the lens
Histologically ,section through the equator shows the hexagonal
structure of lens fibres bound together by ground substanc
Initial fibres are arranged as two y-shaped
sutures, the ant erect-Y & post inverted- Y.
In later stage lens suture arranged
in complicated dendritic
patterns due to asymmetrical
fibre growth
The new lens fibres are laid on the older deeper fibres.
The newly formed cells migrate toward the equator, where they differentiate into fibers. This
area, called the bow region, is where the epithelial cells begin the process of terminal
differentiation into lens fibers is called as lens or nuclear bow.
 STRUCTURE OF LENS FIBRES
The nucleus disappear later on.
Ball & socket and tongue &
groove interdigitation between
cells.
Inter-digitations are less
complicated in superficial zone of
the lens- which permit moulding
of the lens shape on
accommodation
ZONAL ARRANGEMENT OF LENS FIBRES

Fibres arranged in zones due to optical

differences
Nucleus- Central Part— oldest fibres- consists of

Embryonic nucleus- 1 to 3 mth of gestation & is

inner most

Foetal nucleus -3 mth of gestation till birth.

Infantile nucleus -birth to puberty.

Adult nucleus correspond to lens in adult life.

Cortex : Peripheral part, lies outside the adult
nucleus, youngest lens fibres
 APPLIED ASPECT- BIOMICROSCOPY
Concentric layers from front to backwards:-

1. Capsule (Ca)

2. Superficial cortex

Cl a. The Subcapsular clear zone.

C1ß. First zone of disjunction, bright narrow,

C2. Second cortical clear zone or the subclear zone of

cortex.
3. Deep cortex- autofluoresce a brilliant green
under blue exciting light:-

C3. bright light scattering zone.

C4. clear zone of deep cortex.

4. Nucleus (N):-

Central part - lacks scattering of light,

represents the embryonic nucleus.

Anterior and posterior peripheral light

scattering zone of nucleus
 NUCLEAR HARDNESS
Important for phacoemulsification
Hardness depending on colour is graded as :
Green Yellow Yellow Amber Brown Black
 SURGICAL ANATOMY
Four parts

Central hard nucleus

Epinuclear plate

Layer of cortex

Capsule
Although some surgical texts make distinctions between the nucleus, epinucleus,
endonucleus, and cortex, these terms relate only to potential differences in the
behavior and appearance of the material during surgical procedures
 CILIARY ZONULES
A series of fibres which hold the lens in position & enable the ciliary muscle to
act on lens.
Run from ciliary body and fuse into outer layer of capsule around
equatorial region. Transparent, stiff and non elastic.
Susceptible to hydrolysis by chymotrypsin- used to advantage in ICCE
Mutation on chromosome-15 causes
defective fibrillin formation in Marfan's
syndrome and causing ectopia lentis.

Zonular fibres are three different type

Ist Type - thick, wavy

Ilnd Type-thin and flat

Illrd Type - very fine and run in

circular course.
ARRANGEMENT OF ZONULAR
FIBRES
OLD CONCEPT NEW CONCEPT
 RECENT CONCEPTS ABOUT ZONULAR
(A) MAIN ZONULAR FIBRES: FIBRES
four zones.
(1) Pars Orbicularis: Feltwork over pars plana
(2) Zonular Plexuses: lie between ciliary processes in pars plicata region
(3) Zonular Fork: At the anterior margin of pars plicata ,zonular plexuses form a
zonular bundle. This bundle turn to right angle toward lens.
(4) Zonular Limb: The zonular fork divides into three zonular limbs.

(a) Ant Zonular Limb-Zonular fibres c insert anteriorly at equator.

Decrease with increasing age.
(b) Equatorial Zonular Limb-Fibres inserted into capsule of
equatorial region.
(c) Post Zonular Limb-Inserted into posterior capsule
(B) HYALOID ZONULE- Connecting Ant hyaloid with pars plana & pars plicata. Space
between hyaloid zonule and post zonule is called as Canal of petit
(C) HYALOCAPSULAR ZONULE- Probably correspond to ligament of wiegert.
(D) CIRCUMFERENTIAL ZONULAR GIRDLE:-
Ant Cilliary Girdle-Binds cilliary processes with Ant hyaloid membrane.
Post Cilliary Girdle-Binds pars plana 1-2 mm of ora serrata with ant hyaloid membrane.
Scanning electron
micrograph of a
sagittally cut
specimen of the
ciliary body, zonular
fibers, and lens
 BIOCHEMICAL COMPOSITION OF LENS

othe
rs
1%
I. Water-65% prote

II. Protein-34% in
34%

III. Others (lipids, inorganic ions, glucose and its

wat
derivatives,ascorbic acid & amino acids)-1% er
65%

wate protei other

r n s
 WATER
65% (80% free & 20% bound)
Present in dehydrated state (maintained by active Na pump)
Plays Important role in maintenance of lens transparency and refractive index
Cortex is more hydrated than nucleus
PROTEINS
 FUNCTIONS OF CRYSTALLINS
Refractive properties of the lens.
Change in shape observed during the differentiation of an epithelial cell into a
lens fiber.
Provide lens with stress-resistant properties.
Chaperone-like function
Hardness of lens
 AMINOACIDS
Lens contains all AAs except Tryptophan, cysteine, hydroxyprolein
AAs are actively transported into the lens ensures that protein
synthesis is not limited by AA availability.
AA concentration in lens not affected by ageing /fasting or
protein free diet
 CARBOHYDRATES
Glucose:1/10 of aqueous Glucose
th

Fructose- varies with age

Glycogen- localised in nucleus, replaces gamma crystallins to increase
refractive index
Sorbitol
Inositol
 LIPIDS
lubricating cement substance

increases with age esp in nucleus ( similar changes in cataract)

ORGANIC PHOSPHATES
Act as coenzymes in carbohydrate metabolism in lens
No decline with age and cataract
 ELECTROLYTES
K -Predominant Cation- due to large I/c spaces in lens
Na
Ca
Anions(chloride,bicarbonate,phosphate,sulphates)
 GLUTATHIONE
Normally lens constantly exposed to attack by oxidative agents

Glutathione Contributes redox systems in lens microenvironment- detoxifies

agents through mercaptocuric pathway

Also protects thiol groups of proteins of lens.

Catalase and Superoxide dismutase are other imp antioxidants

ASCORBIC ACID
free radical scavenger and thus protect against oxidative damage.
CLINICAL CONSIDERATIONS
Increased oxygen levels in the eye may have a role in cataract formation.
Long-term hyperbaric oxygen therapy leads to myopic shift, increased
opacification of the lens nucleus, and often nuclear cataracts.
The lens is also exposed to increased oxygen acutely during retina procedures and
chronically after vitrectomy.
low oxygen level created by the gel structure of the vitreous body protects the
lens from oxidative damage.
 METABOLISM
Major site – Epithelium
Lens require a continuous supply of energy for:
Active transport lens dehydration and transparency
Continuous protein and GSH Synthesis
SOURCE OF NUTRIENT SUPPLY

From two sources by diffusion

Aqueous humor (main source)
Vitreous humor
 GLUCOSE METABOLISM
Main source of energy
Very essential for normal functioning of lens
Lens can survive without oxygen as long as adequate glucose is available
(not vice versa)
When deprived of glucose - lens looses transparency
So cataracts can develop in infantile hypoglycaemia also
Enters lens from aqueous & vitreous
By simple diffusion
Metabolized through 4 main pathways
A. Anaerobic glycolysis

B. Krebs cycle

C. HMP shunt

D. Sorbital pathway
Anaerobic glycolysis- reduces the problem of oxygen starvation in a tissue which is totally dependent on aqueous , which has rather
low oxygen conc.

80% metabolism of lens

Produces lactic acid- further metabolised or eliminated from eye after diffusion Into aqueous.

Krebs cycle- very inactive in lens. Only 3% glc metabolised by this path.

HMP Shunt- Maintains Glutathione in reduced state

- necessary factor for sorbitol pathway

PROTEIN METABOLISM
Synthesized from free Amino acids
Actively transported into the lens from aqueous
Synthesis of protein is slowest in nucleus
Protein breakdown is catalyzed by peptidases & proteases
SORBITOL
PATHWAY
Normally only 5% glc
metabolised by this path
Pivotal role in sugar cataract
 TRANSPORT MECHANISM
To provide nutrients for metabolism
To regulate water & cation balance in lens
To dispose waste product of metabolism
Transport mechanisms:
Active transport: Amino acids ,K , Taurine , Inositol & Extrusion of Na
Passive transport: Water,Ions,Lactic acid & CO2
 WATER &
ELECTROLYTE
TRANSPORT

By pump-leak mechanism
THE LENS AS AN OSMOMETER

The cations and anions in capsule contribute to lens osmolarity.

The water equilibrium between the lens and the surrounding fluid is disrupted,
if the concentration of osmotically active compounds (Na+, K+, others) increase
inside the lens.
Eg. exposure of the lens to surface active detergent or antibiotics disrupts the
physiochemical integrity of the membrane and gain of Na and water by the lens.
Lens swelling, and eventually, complete loss of lens transparency follows.
ELECTRICAL PHENOMENA OF THE LENS

As a result of distribution of the ions, there exists a resting potential in the lens.

The inside of the lens is -70 mV and −23 mV in the lens fibres.

flow of electrolytes into the lens is directed by electrical gradient

It is hoped that elucidation of electro physiologic finding in the lens might

eventually provide an ideal tool for detecting early membrane changes during
cataractogenesis.
 LENS CULTURE
excellent tissue for in vitro incubation owing to its avascularity and simple
structure.

'closed system' -excised animal lens placed in a culture flask containing an

isotonic oxygenated balanced solution with glucose such as Tyrode's or Krebs-
Ringer solution.

Under such conditions, a lens can be readily maintained for at least 24 hours.

TC 199- used for long-term lens culture for days or weeks.

studies that can be done: glucose utilization, AA transport and lens transparency.
Chemicals or drugs harmful or beneficial to the lens in culture can be tested.
In 2016, an experimental trial in children with congenital cataracts was able to
regenerate working lenses from intact lens epithelial stem cells within six to
eight months. However, no medical treatment can yet prevent the formation or
progression of cataract in the lens of the otherwise healthy adult eye, and theories
about cataract formation and innovative forms of management continue to be
controversial.
 LENS TRANSPARENCY
Thin epithelium

Regular arrangement of lens fibers

Little cellular organelles

Little extracellular space
Lamellar conformation of lens protein
 Lens transprency

Relative dehydration
Semipermeable character of lens capsule

Avascularity

Autooxidation
Pump mechanism of lens fibers
 CHANGES IN AGEING LENS
Changes in ageing lens can be grouped as :
Physical changes
Metabolic change
Changes to Crystallins
Changes to plasma membrane & cytoskeleton
 1.PHYSICAL CHANGES
Lens weight & Thickness increases
Light transmission at lower wavelength decreases while absorbance increases
Light scattering is increased
Fluorescence property of lens increases
2.METABOLIC CHANGES
Proliferative capacity of epithelial cells decreases
Enzyme activities decreases
Glutathione & Ascorbate level decreases
3.CHANGES IN CRYSTALLINS

Alpha-crystallins have been reported to almost disappear from soluble extracts of

nucleus & Beta-crystallins become more polydisperse.
Age-related loss of gamma-crystallins.
4.CHANGES OF PLASMA MEMBRANE &
CYTOSKELETON
Loss of hexagonal cross-section of fibre cells
Lack of cytoskeleton in the lens nucleus
Age-related loss of membrane proteins and lipids
Decrease in large membrane polypeptides
Changes in membrane rigidity
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