Growth of the human lens and the development of its internal features are examined using in vivo and in vitro observations on dimensions, weights, cell sizes, protein gradients and other properties.In vitro studies have shown that human lens growth is biphasic, asymptotic until just after birth and linear for most of postnatal life. This generates two distinct compartments, the prenatal and the postnatal. The prenatal growth mode leads to the formation of an adult nuclear core of fixed dimensions and the postnatal, to an ever-expanding cortex. The nuclear core and the cortex have different properties and can readily be physically separated. Communication and adhesion between the compartments is poor in older lenses.In vivo slit lamp examination reveals several zones of optical discontinuity in the lens. Different nomenclatures have been used to describe these, with the most common recognizing the embryonic, foetal, juvenile and adult nuclei as well as the cortex and outer cortex. Implicit in this nomenclature is the idea that the nuclear zones were generated at defined periods of development and growth.This review examines the relationship between the two compartments observed in vitro and the internal structures revealed by slit lamp photography. Defining the relationship is not as simple as it might seem because of remodeling and cell compaction which take place, mostly in the first 20 years of postnatal life. In addition, different investigators use different nomenclatures when describing the same regions of the lens.From a consideration of the dimensions, the dry mass contents and the protein distributions in the lens and in the various zones, it can be concluded that the juvenile nucleus and the layers contained within it, as well as most of the adult nucleus, were actually produced during prenatal life and the adult nucleus was completed within 3 months after birth, in the final stages of the prenatal growth mode. Further postnatal growth takes place entirely within the cortex. It can also be demonstrated that the in vitro nuclear core corresponds to the combined slit lamp nuclear zones.In view of the information presented in this review, the use of the terms foetal, juvenile and adult nucleus seems inappropriate and should be abandoned.

The purpose of this study was to determine dimensions and curvatures of excised human lenses using the technique of shadowphotogrammetry. A modified optical comparator and digital camera were used to photograph magnified sagittal and coronal lens profiles. Equatorial diameter, anterior and posterior sagittal thickness, anterior and posterior curvatures, and shape factors were obtained from these images. The data were used to calculate lens volumes, which were compared with the lens weights. Measurements were made on 37 human lenses ranging in age from 20 to 99 years. These showed that lens dimensions and the anterior radius of curvature increase linearly throughout adult life while posterior curvature remains constant. The relative shape (or aspect ratio) of the posterior lens is unchanged through adult life since both equatorial diameter and posterior thickness increase at the same rate. The ratio of anterior thickness to posterior thickness is constant at 0.70. It is suggested that in vivo forces alter the apparent location of the lens equator, that the in vitro lens shape corresponds to the maximally accommodated shape in vivo and that the shapes of the accommodated and unaccommodated lens progressively converge toward each other due to lens growth with age, with a convergence point located near the age of total loss of accommodation (55-60 years). Together, these observations provide additional support for the Helmholtz theory of accommodation.

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Prolonged use of glucocorticoids is a significant risk factor for the development of posterior subcapsular cataract. This places restrictions on the use of glucocorticoids in the treatment of systemic and/or ocular inflammatory conditions as well as in organ transplantation.The mechanisms responsible for the opacification are unknown and no effective treatment, other than surgical removal of the lens, is available. Difficulties in establishing suitable in vivo or in vitro models have limited research in this area. Nevertheless, several mechanisms, based on observations with other types of cataracts, have been proposed. In this review, these mechanisms are evaluated in light of the evidence available.A novel mechanism is also proposed, in which steroids do not directly act on the lens but rather affect the balance of ocular cytokines and growth factors.