LENS

DEFINITION :

▪ The lens is a transparent, Biconvex crystalline structure.

▪ It placed between iris and vitreous in a saucer depression the Petallar
fossa.
▪ Diameter is 9-10mm.
▪ Thickness varies with age.
▪ It has 2 surfaces:
▪ Anterior surface – less convex
▪ Posterior surface – more convex

STRUCTURE:

▪ Lens capsule
▪ Lens epithelium
▪ Cortex
▪ Nucleus – Embryonic, Fetal, Infantile and Adult Nucleus
FUNCTIONS:

▪ Refraction
▪ It accounts for 35% of refractive power of eye(15D)
▪ Light transmission (focusing light on retina)
▪ Absorb UV rays
▪ Accommodation

LENS TRANSPARENCY :

Factors:

▪ Avascularity of the lens

▪ Epithelium is single layer
▪ Lens capsule is semipermeable character
▪ Characteristics of lens fibers:
➢ Tightly packed of lens
➢ Loss of organelles
➢ Role of lens proteins
▪ Pump mechanism of lens fiber membranes – regulate electrolyte and
water balance in the lens
▪ Auto oxidation and high concentration of reduced glutathione in the lens

CHANGES IN AGING LENS :

PHYSICAL CHANGES :

• Lens weight & Thickness increase

• Fluorescence property of lens increase
• Light transmission decrease
• Light Scatter decrease

METABOLIC CHANGES :

• Proliferative Capacity of epithelial cells decrease

• Enzyme activity decrease
• Glutathione & Ascorbate level decreases

CHANGES IN CRYSTALLLINE :

• Age related loss of alpha, beta and gamma proteins.

CHANGES OF PLASMA MEMBRANE AND CYTOSKELETON :

• Loss of hexagonal cross section of lens fiber cells

• Lack of cytoskeleton in the nucleus
• Age related loss of membrane proteins
• Decrease level of polypeptides

CATARACT :

DEFINITION :

• It refers to development of any opacity in the lens & it’s capsule.

• Due to formation of opaque lens fibers.
TYPES:

Etiological Types:

• Congenital
• Acquired – Senile, Traumatic, Complicated, Metabolic and Toxic
Cataract.

Morphological Types:

• Capsular Cataract
• Sub Capsular Cataract
• Cortical Cataract
• Nuclear Cataract
Based on degree of maturity:

• Immature cataract
• Mature cataract
• Hyper mature cataract
• Morganian cataract

CAUSES :

• Gradual breakdown of lens proteins.

• Heredity
• Alcohol/ Tobacco/ Smoke
• Industrial Chemicals
• UV Exposure
• Air pollution
• Radiation Therapy
• High blood sugar
• Glaucoma Surgery
• Uveitis
• Retinitis Pigmentosa
• Corticosteroids
SYMPTOMS:

• Blur vision
• Foggy vision
• Color fade
• Sensitivity to light/ Glare
• Halos
• Difficulty seeing at night time
• Double vision

DIAGNOSIS :

• Visual acuity test

• Slit lamp examination

TREATMENT :

• Eye Glasses
• Better Lightening
• Surgery :-
1. ECCE – Extra Capsular Cataract Extraction
2. ICCE – Intra Capsular Cataract Extraction (not performed now)
3. Phacoemulsification