LENS
ANATOMY & PHYSIOLOGY OF LENS
ACCOMMODATIVE APPARATUS &
ITS MECHANISM
LAYOUT
o INTRODUCTION
o EMBRYOLOGY
o ANATOMY
o PHYSIOLOGY
o ACCOMMODATION
INTRODUCTION
Asymmetric oblate spheroid
Does not possess nerves, blood
vessels, or connective tissue
Transparent
Crystalline structure
Prolate spheroid Oblate spheroid
DEVELOPMENT OF THE LENS
Derived from surface ectoderm
First apparent at about 25 days
of gestation
LENS PLACODE :
Appears on 27th day of gestation
Area of thickened cells is called
lens plate or lens placode
LENS PIT:
Appears at 29th day of gestation
Lens placode & adjacent cells of
optic vesicle invaginates inward
to form lens pit
Also known as Fovea Lentis
LENS VESICLE:
Formed at about 33rd day of
gestation
Lens pit separates from surface
ectoderm and forms lens vesicle
LENS CAPSULE
During process of invagination, the basal lamina comes
to surround lens vesicle
Basal lamina gradually thickens by deposition of
successive layers of basal lamina material to form Lens
Capsule
PRIMARY LENS FIBERS AND THE EMBRYONIC NUCLEUS
Posterior cells of lens vesicles rapidly
elongate and obliterate the lumen of
the cavity
By 45th day of gestation the lumen is
completely obliterated and the cells
are called Primary lens fibers
Make up the Embryonic nucleus that
will occupy the central area of lens in
adult life
DEVELOPING LENS EPITHELIUM
Cells of anterior lens vesicle form
Lens epithelium
SECONDARY LENS FIBERS
Pre-equatorial cells of lens epithelium form the
Secondary lens fibers
Starting from the 7th week of gestation
Anterior aspect of fibers grow
towards the anterior pole and
posterior aspect grows towards
posterior pole of the lens
Meet on the vertical planes, the
Lens sutures
LENS SUTURE AND FETAL NUCLEUS:
These are formed only
during fetal life
Erect Y anteriorly and
inverted Y posteriorly
As secondary fibers are added, the sutures
become more complex and dendriform
The secondary lens fibers formed between 2nd to
8th months of gestation make up the fetal nucleus
After birth symmetrical branching of sutures
results stellate structure in adult nucleus
APPLIED ANATOMY
SUTURAL CATARACT
Opacification of Y-suture of fetal
nucleus
FORMATION OF LENS CAPSULE
Lens epithelial & superficial fiber cells continue to
secrete components of basal lamina, which thickens to
become lens capsule
TUNICA VASCULOSA LENTIS
Vascular mesenchymal layer
Arises from hyaloid artery
Source of nourishment to lens in fetal period
At 1st month of gestation, Hyaloid
artery gives rise to small capillaries
which forms the Posterior pupillary
membrane, a network covering
posterior surface of the lens capsule
Fully developed at 9th week of
gestation
During human development,
capillaries of tunica vasculosa lentis
and anterior pupillary membrane
regress
CLINICAL SIGNIFICANCE OF VASCULOSA LENTIS:
PERSISTENT PUPILLARY MEMBRANE
REMNANT OF THE ANTERIOR PUPILLARY MEMBRANE
Often visible in young healthy patients as pupillary
stands
Minimal visual obscuration
MITTENDORF DOT
REMNANT OF THE POSTERIOR
PUPILLARY MEMBRANE
Small, dense white spot located
mostly infero nasally to the posterior
pole of lens
Marks the place where hyaloid artery
comes into contact with the posterior
surface of the lens
DEVELOPMENTAL ANOMALIES OF THE LENS
SHAPE
1. Lenticonus / Lentiglobus
2. Coloboma
3. Microphakia / Microspherophakia
LENTICONUS
Circumscribed conical protrusion of the lenticular pole
Anterior lenticonus is seen in patients with Alport’s syndrome
Posterior lenticonus is seen patients with Lowe’s syndrome
LENTIGLOBUS
Hemispherical protrusion of the lens
Localized deformation of the lens surface is spherical
Symptoms include myopia and reduced visual acuity
Appear as an "oil droplet” on retro illumination
LENS COLOBOMA
Primary:
Wedge shaped defect or indentation
of the lens in periphery. It mostly
occurs as an isolated anomaly
Secondary:
A flattening or indentation of the lens
periphery caused by lack of ciliary body
or zonular development
These are typically inferior and may be
associated with colobomas of uvea
MICROSPHEROPHAKIA
Lens small in diameter and spherical in shape
Visible lens equator
High myopia
Due to faulty development of secondary lens fibers
CONGENITAL APHAKIA
Very rare
Complete absence of lens
May be primary or secondary.
PRIMARY:
 lens placode fails to develop from the
surface ectoderm
SECONDARY:
 more common, developing lens is
spontaneously absorbed
STRUCTURAL ANATOMY
DIMENSION
Equatorial diameter
• At birth: 6.5 mm
• In adult: 9-10 mm
Antero posterior/Axial
length/Thickness
• At birth: 3.5 mm
• In adult: 4.75–5 mm
(unaccommodated)
9 mm
5 mm
WEIGHT
• at birth: 65-90 mg
• in adult: 255 mg
 Increases by rate of 2 mg/year
SURFACES
• Anterior surface:
• Less convex (8-14 mm)
• Anterior pole
• Posterior surface:
• More curved (4.5-7.5 mm)
• Posterior pole
Optical Axis: line joining the two poles
REFRACTIVE PROPERTIES
REFRACTIVE INDEX
• Peripheral cortex :1.386
• Central nucleus :1.41
Anterior capsular surface has more R.I than posterior
Depends upon protein concentration and lens fibers
Slightly more than aqueous and vitreous humor
REFRACTIVE POWER
16-17 D
Cornea 1.37
Cornea +43 D
Eye
Eye +60 D
EQUATOR
Marginal circumference of lens,
where anterior and posterior
surface meets
Encircled by ciliary processes of
ciliary body and held in position
by zonules laterally
ANATOMICAL RELATIONS
Anterior Surface: Behind the
Anterior chamber & Posterior
surface of the iris
Lateral Surface: Posterior
chamber of the eye and to the
zonules through ciliary
processes
~3 mm
Posterior Surface: Vitreous which is separated Berger’s
space filled with aqueous and is attached to the
posterior surface in a circular fashion by ligamentum
hyaloideocapsulare (Wiegert’s ligament)
STRUCTURE
Histologically composed of 3 structures:
1. Lens Capsule
2. Anterior Lens Epithelium
3. Lens Fibers
CAPSULE
Transparent,Hyaline collagenous membrane
completely envelops the lens
Thickest basement membrane in the body, produced
throughout life
Secreted by (basal part of) lens epithelium anteriorly and
elongating cortical fibers posteriorly
Thickness of anterior capsule increases with age and that
of posterior remains constant
No elastic tissue present but highly elastic due
to lamellar or fibrillar arrangement
Capsule is permeable to water, ions and small
molecules and offers barrier to protein
molecule, albumin & Hb
ARRANGEMENT OF ZONULAR FIBERS
Zonular fibers arise from the posterior end of
pars plana (~1.5mm from ora serrata)
Zonular complex can be divided into 4 zones
Pars orbicularis :- Passes forward over the pars
plana from its origin
Zonular plexus :- Zonular fibers segments into
Zonular plexus
Zonular fork :- Zonular plexus consolidate into
Zonular bundles and bends at right angle to proceed
to lens.
Zonular limbs :- 3 in number
Anterior zonular limbs / orbiculo-anterior capsular fibers
Equatorial zonular limbs /cilio-equatorial fibers
Posterior zonular limbs / orbiculo-posterior capsular fibers
INSERTION OF THE ZONULAR FIBERS
Anteriorly and posteriorly at periphery and at equator of
the lens
The layer of inserting zonular fibers and the related
capsular layer are termed Zonular lamella
Non-elastic
Collectively referred to as the suspensory ligaments of the
lens.
ZONULAR LAMELLA
Less compact
Richer in glycosaminoglycans than the rest of the
capsule
The lamella contributes to the zonular adhesive
mechanism
Pericapsular membrane
APPLIED ANATOMY
Ectopia lentis
Displacement of lens from its normal position
May be congenital, developmental or acquired
May be dislocated or subluxated
Subluxation: partially displaced
from normal position but remains
in the pupillary area.
Dislocation: complete
displacement from pupil i.e.
separation of all zonular
attachments
Associated with systemic feature
1. Marfan syndrome :- upward & temporal displacement
2. Homocystinuria :- downward and nasal subluxation
3. Weil-Marchesani syndrome :- forward subluxation
LENS EPITHELIUM
Single layered
Deep to anterior lens
capsule
Secretes anterior lens
capsule throughout life
Increased density
toward the periphery.
No corresponding posterior layer is present as the cells are used up in
filling the central cavity of the lens vesicle.
1. Central zone
2. Intermediate/ Tansitional zone
3. Germinative zone
ZONES OF LENS EPITHELIUM
Amount of Cells reduces with age
Do not mitose
Provides well defined cytoskeleton due to proteins like
actin, vimentin and microtubulin
INTERMEDIATE ZONE
Peripheral to central zone
CENTRAL ZONE
Most peripheral
Major site of cell differentiation
Highest metabolic capacity
GERMINATIVE ZONE
From this region new cells migrate posteriorly to
become lens fibers
Play the primary role in regulating the water and ion
balance
Germinative zone, unlike the central zone (lies in
pupillary aperture) is protected from the harmful
effects of UV radiation by its location behind the iris
LENS FIBERS
Hexagonal in cross-section
Formed constantly at
equator throughout life
from germinative cells
Primary lens fibers are formed from the posterior
epithelium during embryogenesis
Secondary lens fibers are formed by
differentiation from germinative cells
ELONGATION OF LENS FIBERS
Secondary lens fibers elongates anteriorly and
posteriorly.
Anterior aspect of lens fiber extend anteriorly beneath
the lens epithelium, toward anterior pole of the lens.
Posterior aspect extends posteriorly along the capsule
towards the posterior pole of the lens
Reach the sutures,
stop elongating
and their basal
ends detach from
the capsule.
Lose all cellular organelles (nuclei, mitochondria,
ribosomes)
Lack independent metabolic activity
Depends upon glycolysis for energy
LENS FIBRE ULTRASTRUCTURE
SUPERFICIAL LAYERS
“Ball and Socket” like joints arranged regularly along
the length of the fiber
Mainly important for the movement of the fibers during
accommodation.
DEEPER LAYER OF CORTEX AND THE NUCLEUS
Tongue and groove joints
Essential for the continuing transparency of the lens along
with providing limited degree of fiber sliding and
flexing of lens structure whole of which is a requirement
of accommodation.
LENS FIBRE ULTRASTRUCTURE
Ball and
socket joints
Tongue and
groove joints
Lens Fibers are laid down in concentric layers
•Cortex (outermost)
•Nucleus (innermost)
ZONES OF LENS FIBER
NUCLEUS
Central part, containing oldest fibers
Fibers arranged in compact fashion
so harder in consistency
CORTEX
Peripheral part, composed of
recently formed fibers
Fibers loosely arranged so soft in
consistency
Nucleus
Cortex
LAYERS OF NUCLEUS
Embryonic:
Innermost
Primary lens fibers formed in the
lens vesicle during embryogenesis
Fetal:
From 3 month to birth
Infantile:
Birth to puberty
Adult :
Corresponds to adult lens
COMPOSITION OF LENS FIBER
LENS FIBRE PROTEINS
1. Insoluble protein i.e albuminoid
2. Soluble proteins are alpha, beta and gamma crystallins
CYTOSKELETAL ELEMENTS
Actin, vimentin, and tubulin
Stabilize the fiber cell membrane.
LENS CRYSTALLIN
Two alpha crystallin ‘alpha-A’ and ‘alpha-B’
Alpha crystalline functions in preventing protein
aggregation and precipitation
Reduces the amount of light being scattered
SUTURES
Junctions between the apical and
basal end of the cells from the
opposite sides of the lens fibers
ANTERIOR:
Erect Y shaped and formed by
interdigitation of apical cell processes
POSTERIOR:
Inverted Y shaped and formed by
interdigitation of basal cell processes
Later on, the growth of the lens suture is irregular
Thus newly formed sutures have dendritic pattern
Increasing geometrical complexity of suture
pattern in adult human lenses results in better
optical properties
BIOCHEMISTRY
WATER
Low amount of water to maintain the refractive index
Lens dehydration maintained by active sodium pump
Cortex more hydrated than nucleus
PROTEIN
Water soluble (80%) :- crystallin – alpha(32%), beta(55%) and
gamma(1.5%)
FUNCTION OF CRYSTALLIN
Refractive function
Change of shape during cell differentiation
Stress-resistant & oxidative properties
Chaperone-like functions
Prevent insolubilization of heat denatured proteins
Facilitate the renaturation of proteins that have
been chemically denaturated
Main site – lens epithelium
Main Aims
1. Lens transparency
2. Accommodation
3. Carbohydrate metabolism
4. Regulation of lens electrolyte balance to maintain
normal hydration of the lens
5. Protection of the lens from oxidative damage
LENS PHYSIOLOGY
LENS TRANSPARENCY
Normally transmits 80% light energy
Result of:-
1. Single(thin) layer of Epithelial cells
2. Semi permeable lens capsule
3. Highly packed structure of lens fibers (zones of
discontinuity much smaller than the wavelength of
light)
4. Characteristic arrangement of lens protein
5. Pump mechanism of lens fibers(which regulates the
electrolyte and water balance)
6. Avascularity
7. Auto-oxidation (ensuring integrity of membrane
pumps)
ACCOMMODATION
Accommodation is a change in refractive state of eye
d/t alternation of curvature of the crystalline lens as a
result of the action of the ciliary muscle on the zonular
fibers
Purpose: Focus and maximize spatial contrast of the
foveal retinal image.
ACCOMMODATIVE APPARATUS
Ciliary body and Ciliary muscle fibers
Lens capsule
Zonules
CILIARY BODY & CILIARY MUSCLE FIBEES
Forward continuation of choroid at ora serrate
3 types of ciliary muscle fibres
1. Circular Fibers
2. Longitudinal/ Meridional Fibers
3. Radial Fibers
Function :- Slacken the suspensory ligaments of lens
& thus helps in accommodation
MECHANISM OF ACCOMMODATION IN HUMAN
Explained by relaxation theory
In unaccommodated state
Ciliary muscle relax
Suspensory ligament is at its greatest tension
Lens takes flattest curves &
Retina is conjugate with far point
Ciliary muscle is constricted
Zonules of zinn relaxes
Allows the lens to make a more convex form &
Retina is conjugate with near point
In Accommodated state
CHANGES IN OCULAR DIMENSION
➢ Decrease in equatorial diameter of the lens (by 0.4 mm from 10
to 9.6mm)
➢ Pupil constricts
➢ Pupillary margin of iris & ant surface of lens move forward
➢ Decrease in radius of curvature of ant. (by 5.5 mm from 11-
5.5mm) and post. lens surface
➢ Forward movement of lens (reduced anterior chamber)
➢ Increased lenticular thickness (by 0.5 mm from 3.5-4mm)
➢ Lens sinks downward
➢ Choroid moves forward
➢ Optically each of these changes increases refractive power of
the eye i.e. eye accommodates
CHANGES IN ACCOMMODATIVE POWER
AT BIRTH: 14-15 D
AT 50 YEARS: 1-2 D
AT 25 YEARS: 7-8 D
Amplitude = 4X4 - (age/4)
METABOLISM
Lens requires a continuous supply of energy
(ATP) for :
Active transport of ions & amino acids
Maintenance of lens dehydration
Continuous protein synthesis
Source of nutrient
Avascular structure
Takes nutrients from two sources by diffusion
1. Aqueous humour (main source)
2. Vitreous humour
APPLIED ANATOMY
CATARACTOGENESIS
Disturbance in transparency of lens
leads to its opacification
Occurrence of an optical discontinuity in
the lens of such magnitude as to cause a
noticeable dispersion of light
May be congenital or acquired
ACQUIRED CATARACT
AGE RELATED CATARACT
Commonest type of cataract
Usually above 50 years
Usually bilateral
Multifactorial
Nuclear sclerosis
Exagerration of normal ageing
changes
Increased yellowish hue
Cortical cataract
Involves anterior, posterior or
equatorial cortex
Spokes like opacities
Subcapsular cataract
Anterior subcapsular
Lies directly under the lens capsule
Fibrous metaplasia of lens epithelium
Posterior subcapsular
Lies in front of posterior capsule
Vacuolated, granular or plaque like
REFERENCES
THANK YOU

Crystalline Lens

  • 1.
    LENS ANATOMY & PHYSIOLOGYOF LENS ACCOMMODATIVE APPARATUS & ITS MECHANISM
  • 2.
    LAYOUT o INTRODUCTION o EMBRYOLOGY oANATOMY o PHYSIOLOGY o ACCOMMODATION
  • 3.
    INTRODUCTION Asymmetric oblate spheroid Doesnot possess nerves, blood vessels, or connective tissue Transparent Crystalline structure Prolate spheroid Oblate spheroid
  • 4.
    DEVELOPMENT OF THELENS Derived from surface ectoderm First apparent at about 25 days of gestation
  • 5.
    LENS PLACODE : Appearson 27th day of gestation Area of thickened cells is called lens plate or lens placode
  • 6.
    LENS PIT: Appears at29th day of gestation Lens placode & adjacent cells of optic vesicle invaginates inward to form lens pit Also known as Fovea Lentis
  • 7.
    LENS VESICLE: Formed atabout 33rd day of gestation Lens pit separates from surface ectoderm and forms lens vesicle
  • 8.
    LENS CAPSULE During processof invagination, the basal lamina comes to surround lens vesicle Basal lamina gradually thickens by deposition of successive layers of basal lamina material to form Lens Capsule
  • 9.
    PRIMARY LENS FIBERSAND THE EMBRYONIC NUCLEUS Posterior cells of lens vesicles rapidly elongate and obliterate the lumen of the cavity By 45th day of gestation the lumen is completely obliterated and the cells are called Primary lens fibers Make up the Embryonic nucleus that will occupy the central area of lens in adult life
  • 10.
    DEVELOPING LENS EPITHELIUM Cellsof anterior lens vesicle form Lens epithelium
  • 11.
    SECONDARY LENS FIBERS Pre-equatorialcells of lens epithelium form the Secondary lens fibers Starting from the 7th week of gestation
  • 12.
    Anterior aspect offibers grow towards the anterior pole and posterior aspect grows towards posterior pole of the lens Meet on the vertical planes, the Lens sutures
  • 13.
    LENS SUTURE ANDFETAL NUCLEUS: These are formed only during fetal life Erect Y anteriorly and inverted Y posteriorly
  • 14.
    As secondary fibersare added, the sutures become more complex and dendriform The secondary lens fibers formed between 2nd to 8th months of gestation make up the fetal nucleus After birth symmetrical branching of sutures results stellate structure in adult nucleus
  • 15.
  • 16.
    FORMATION OF LENSCAPSULE Lens epithelial & superficial fiber cells continue to secrete components of basal lamina, which thickens to become lens capsule
  • 17.
    TUNICA VASCULOSA LENTIS Vascularmesenchymal layer Arises from hyaloid artery Source of nourishment to lens in fetal period
  • 18.
    At 1st monthof gestation, Hyaloid artery gives rise to small capillaries which forms the Posterior pupillary membrane, a network covering posterior surface of the lens capsule Fully developed at 9th week of gestation During human development, capillaries of tunica vasculosa lentis and anterior pupillary membrane regress
  • 19.
    CLINICAL SIGNIFICANCE OFVASCULOSA LENTIS: PERSISTENT PUPILLARY MEMBRANE REMNANT OF THE ANTERIOR PUPILLARY MEMBRANE Often visible in young healthy patients as pupillary stands Minimal visual obscuration
  • 20.
    MITTENDORF DOT REMNANT OFTHE POSTERIOR PUPILLARY MEMBRANE Small, dense white spot located mostly infero nasally to the posterior pole of lens Marks the place where hyaloid artery comes into contact with the posterior surface of the lens
  • 21.
    DEVELOPMENTAL ANOMALIES OFTHE LENS SHAPE 1. Lenticonus / Lentiglobus 2. Coloboma 3. Microphakia / Microspherophakia
  • 22.
    LENTICONUS Circumscribed conical protrusionof the lenticular pole Anterior lenticonus is seen in patients with Alport’s syndrome Posterior lenticonus is seen patients with Lowe’s syndrome
  • 23.
    LENTIGLOBUS Hemispherical protrusion ofthe lens Localized deformation of the lens surface is spherical Symptoms include myopia and reduced visual acuity Appear as an "oil droplet” on retro illumination
  • 24.
    LENS COLOBOMA Primary: Wedge shapeddefect or indentation of the lens in periphery. It mostly occurs as an isolated anomaly Secondary: A flattening or indentation of the lens periphery caused by lack of ciliary body or zonular development These are typically inferior and may be associated with colobomas of uvea
  • 25.
    MICROSPHEROPHAKIA Lens small indiameter and spherical in shape Visible lens equator High myopia Due to faulty development of secondary lens fibers
  • 26.
    CONGENITAL APHAKIA Very rare Completeabsence of lens May be primary or secondary. PRIMARY:  lens placode fails to develop from the surface ectoderm SECONDARY:  more common, developing lens is spontaneously absorbed
  • 27.
    STRUCTURAL ANATOMY DIMENSION Equatorial diameter •At birth: 6.5 mm • In adult: 9-10 mm Antero posterior/Axial length/Thickness • At birth: 3.5 mm • In adult: 4.75–5 mm (unaccommodated) 9 mm 5 mm
  • 28.
    WEIGHT • at birth:65-90 mg • in adult: 255 mg  Increases by rate of 2 mg/year SURFACES • Anterior surface: • Less convex (8-14 mm) • Anterior pole • Posterior surface: • More curved (4.5-7.5 mm) • Posterior pole Optical Axis: line joining the two poles
  • 29.
    REFRACTIVE PROPERTIES REFRACTIVE INDEX •Peripheral cortex :1.386 • Central nucleus :1.41 Anterior capsular surface has more R.I than posterior Depends upon protein concentration and lens fibers Slightly more than aqueous and vitreous humor REFRACTIVE POWER 16-17 D Cornea 1.37 Cornea +43 D Eye Eye +60 D
  • 30.
    EQUATOR Marginal circumference oflens, where anterior and posterior surface meets Encircled by ciliary processes of ciliary body and held in position by zonules laterally
  • 31.
    ANATOMICAL RELATIONS Anterior Surface:Behind the Anterior chamber & Posterior surface of the iris Lateral Surface: Posterior chamber of the eye and to the zonules through ciliary processes ~3 mm
  • 32.
    Posterior Surface: Vitreouswhich is separated Berger’s space filled with aqueous and is attached to the posterior surface in a circular fashion by ligamentum hyaloideocapsulare (Wiegert’s ligament)
  • 33.
    STRUCTURE Histologically composed of3 structures: 1. Lens Capsule 2. Anterior Lens Epithelium 3. Lens Fibers
  • 34.
    CAPSULE Transparent,Hyaline collagenous membrane completelyenvelops the lens Thickest basement membrane in the body, produced throughout life Secreted by (basal part of) lens epithelium anteriorly and elongating cortical fibers posteriorly Thickness of anterior capsule increases with age and that of posterior remains constant
  • 36.
    No elastic tissuepresent but highly elastic due to lamellar or fibrillar arrangement Capsule is permeable to water, ions and small molecules and offers barrier to protein molecule, albumin & Hb
  • 37.
    ARRANGEMENT OF ZONULARFIBERS Zonular fibers arise from the posterior end of pars plana (~1.5mm from ora serrata) Zonular complex can be divided into 4 zones Pars orbicularis :- Passes forward over the pars plana from its origin Zonular plexus :- Zonular fibers segments into Zonular plexus
  • 38.
    Zonular fork :-Zonular plexus consolidate into Zonular bundles and bends at right angle to proceed to lens. Zonular limbs :- 3 in number Anterior zonular limbs / orbiculo-anterior capsular fibers Equatorial zonular limbs /cilio-equatorial fibers Posterior zonular limbs / orbiculo-posterior capsular fibers
  • 39.
    INSERTION OF THEZONULAR FIBERS Anteriorly and posteriorly at periphery and at equator of the lens The layer of inserting zonular fibers and the related capsular layer are termed Zonular lamella Non-elastic Collectively referred to as the suspensory ligaments of the lens.
  • 40.
    ZONULAR LAMELLA Less compact Richerin glycosaminoglycans than the rest of the capsule The lamella contributes to the zonular adhesive mechanism Pericapsular membrane
  • 41.
    APPLIED ANATOMY Ectopia lentis Displacementof lens from its normal position May be congenital, developmental or acquired May be dislocated or subluxated
  • 42.
    Subluxation: partially displaced fromnormal position but remains in the pupillary area. Dislocation: complete displacement from pupil i.e. separation of all zonular attachments
  • 43.
    Associated with systemicfeature 1. Marfan syndrome :- upward & temporal displacement 2. Homocystinuria :- downward and nasal subluxation 3. Weil-Marchesani syndrome :- forward subluxation
  • 44.
    LENS EPITHELIUM Single layered Deepto anterior lens capsule Secretes anterior lens capsule throughout life Increased density toward the periphery. No corresponding posterior layer is present as the cells are used up in filling the central cavity of the lens vesicle.
  • 45.
    1. Central zone 2.Intermediate/ Tansitional zone 3. Germinative zone ZONES OF LENS EPITHELIUM
  • 46.
    Amount of Cellsreduces with age Do not mitose Provides well defined cytoskeleton due to proteins like actin, vimentin and microtubulin INTERMEDIATE ZONE Peripheral to central zone CENTRAL ZONE
  • 47.
    Most peripheral Major siteof cell differentiation Highest metabolic capacity GERMINATIVE ZONE
  • 48.
    From this regionnew cells migrate posteriorly to become lens fibers Play the primary role in regulating the water and ion balance Germinative zone, unlike the central zone (lies in pupillary aperture) is protected from the harmful effects of UV radiation by its location behind the iris
  • 50.
    LENS FIBERS Hexagonal incross-section Formed constantly at equator throughout life from germinative cells
  • 51.
    Primary lens fibersare formed from the posterior epithelium during embryogenesis Secondary lens fibers are formed by differentiation from germinative cells
  • 52.
    ELONGATION OF LENSFIBERS Secondary lens fibers elongates anteriorly and posteriorly. Anterior aspect of lens fiber extend anteriorly beneath the lens epithelium, toward anterior pole of the lens. Posterior aspect extends posteriorly along the capsule towards the posterior pole of the lens
  • 53.
    Reach the sutures, stopelongating and their basal ends detach from the capsule.
  • 54.
    Lose all cellularorganelles (nuclei, mitochondria, ribosomes) Lack independent metabolic activity Depends upon glycolysis for energy
  • 55.
    LENS FIBRE ULTRASTRUCTURE SUPERFICIALLAYERS “Ball and Socket” like joints arranged regularly along the length of the fiber Mainly important for the movement of the fibers during accommodation.
  • 56.
    DEEPER LAYER OFCORTEX AND THE NUCLEUS Tongue and groove joints Essential for the continuing transparency of the lens along with providing limited degree of fiber sliding and flexing of lens structure whole of which is a requirement of accommodation. LENS FIBRE ULTRASTRUCTURE Ball and socket joints Tongue and groove joints
  • 57.
    Lens Fibers arelaid down in concentric layers •Cortex (outermost) •Nucleus (innermost)
  • 58.
    ZONES OF LENSFIBER NUCLEUS Central part, containing oldest fibers Fibers arranged in compact fashion so harder in consistency CORTEX Peripheral part, composed of recently formed fibers Fibers loosely arranged so soft in consistency Nucleus Cortex
  • 59.
    LAYERS OF NUCLEUS Embryonic: Innermost Primarylens fibers formed in the lens vesicle during embryogenesis Fetal: From 3 month to birth Infantile: Birth to puberty Adult : Corresponds to adult lens
  • 60.
    COMPOSITION OF LENSFIBER LENS FIBRE PROTEINS 1. Insoluble protein i.e albuminoid 2. Soluble proteins are alpha, beta and gamma crystallins CYTOSKELETAL ELEMENTS Actin, vimentin, and tubulin Stabilize the fiber cell membrane.
  • 61.
    LENS CRYSTALLIN Two alphacrystallin ‘alpha-A’ and ‘alpha-B’ Alpha crystalline functions in preventing protein aggregation and precipitation Reduces the amount of light being scattered
  • 62.
    SUTURES Junctions between theapical and basal end of the cells from the opposite sides of the lens fibers ANTERIOR: Erect Y shaped and formed by interdigitation of apical cell processes POSTERIOR: Inverted Y shaped and formed by interdigitation of basal cell processes
  • 63.
    Later on, thegrowth of the lens suture is irregular Thus newly formed sutures have dendritic pattern Increasing geometrical complexity of suture pattern in adult human lenses results in better optical properties
  • 64.
  • 65.
    WATER Low amount ofwater to maintain the refractive index Lens dehydration maintained by active sodium pump Cortex more hydrated than nucleus PROTEIN Water soluble (80%) :- crystallin – alpha(32%), beta(55%) and gamma(1.5%)
  • 66.
    FUNCTION OF CRYSTALLIN Refractivefunction Change of shape during cell differentiation Stress-resistant & oxidative properties Chaperone-like functions Prevent insolubilization of heat denatured proteins Facilitate the renaturation of proteins that have been chemically denaturated
  • 67.
    Main site –lens epithelium Main Aims 1. Lens transparency 2. Accommodation 3. Carbohydrate metabolism 4. Regulation of lens electrolyte balance to maintain normal hydration of the lens 5. Protection of the lens from oxidative damage LENS PHYSIOLOGY
  • 68.
    LENS TRANSPARENCY Normally transmits80% light energy Result of:- 1. Single(thin) layer of Epithelial cells 2. Semi permeable lens capsule 3. Highly packed structure of lens fibers (zones of discontinuity much smaller than the wavelength of light)
  • 69.
    4. Characteristic arrangementof lens protein 5. Pump mechanism of lens fibers(which regulates the electrolyte and water balance) 6. Avascularity 7. Auto-oxidation (ensuring integrity of membrane pumps)
  • 70.
    ACCOMMODATION Accommodation is achange in refractive state of eye d/t alternation of curvature of the crystalline lens as a result of the action of the ciliary muscle on the zonular fibers Purpose: Focus and maximize spatial contrast of the foveal retinal image.
  • 71.
    ACCOMMODATIVE APPARATUS Ciliary bodyand Ciliary muscle fibers Lens capsule Zonules
  • 72.
    CILIARY BODY &CILIARY MUSCLE FIBEES Forward continuation of choroid at ora serrate 3 types of ciliary muscle fibres 1. Circular Fibers 2. Longitudinal/ Meridional Fibers 3. Radial Fibers Function :- Slacken the suspensory ligaments of lens & thus helps in accommodation
  • 73.
    MECHANISM OF ACCOMMODATIONIN HUMAN Explained by relaxation theory In unaccommodated state Ciliary muscle relax Suspensory ligament is at its greatest tension Lens takes flattest curves & Retina is conjugate with far point
  • 74.
    Ciliary muscle isconstricted Zonules of zinn relaxes Allows the lens to make a more convex form & Retina is conjugate with near point In Accommodated state
  • 75.
    CHANGES IN OCULARDIMENSION ➢ Decrease in equatorial diameter of the lens (by 0.4 mm from 10 to 9.6mm) ➢ Pupil constricts ➢ Pupillary margin of iris & ant surface of lens move forward ➢ Decrease in radius of curvature of ant. (by 5.5 mm from 11- 5.5mm) and post. lens surface ➢ Forward movement of lens (reduced anterior chamber) ➢ Increased lenticular thickness (by 0.5 mm from 3.5-4mm) ➢ Lens sinks downward ➢ Choroid moves forward ➢ Optically each of these changes increases refractive power of the eye i.e. eye accommodates
  • 76.
    CHANGES IN ACCOMMODATIVEPOWER AT BIRTH: 14-15 D AT 50 YEARS: 1-2 D AT 25 YEARS: 7-8 D Amplitude = 4X4 - (age/4)
  • 77.
    METABOLISM Lens requires acontinuous supply of energy (ATP) for : Active transport of ions & amino acids Maintenance of lens dehydration Continuous protein synthesis
  • 78.
    Source of nutrient Avascularstructure Takes nutrients from two sources by diffusion 1. Aqueous humour (main source) 2. Vitreous humour
  • 80.
    APPLIED ANATOMY CATARACTOGENESIS Disturbance intransparency of lens leads to its opacification Occurrence of an optical discontinuity in the lens of such magnitude as to cause a noticeable dispersion of light May be congenital or acquired
  • 81.
    ACQUIRED CATARACT AGE RELATEDCATARACT Commonest type of cataract Usually above 50 years Usually bilateral Multifactorial
  • 82.
    Nuclear sclerosis Exagerration ofnormal ageing changes Increased yellowish hue Cortical cataract Involves anterior, posterior or equatorial cortex Spokes like opacities
  • 83.
    Subcapsular cataract Anterior subcapsular Liesdirectly under the lens capsule Fibrous metaplasia of lens epithelium Posterior subcapsular Lies in front of posterior capsule Vacuolated, granular or plaque like
  • 84.
  • 85.