Lamellar separation in the human lens: the case for fibre folds. A combined in vivo and electron microscopy study.

Lamellar separation is seen as parallel lines in the lens cortex. It has been the subject of a joint study between Oxford and Amsterdam. The condition was studied in vivo by macro photography and in vitro by scanning electron microscopy. The lines are seen to run concentric with the lens equator, crossing the lens fibres at right angles. The lines are commonly limited by a spoke cataract, a water cleft, or a lens suture. The line may continue beyond these features with a change in direction. The lines may branch and rejoin. The lines extend in depth into the lens, polarised light showing that the lines are due to reflection. The name 'lamellar separation' implied that the appearance is due to separation between the lens lamellae. Lamellar separation is now shown by electron microscopy to be due to folds crossing the lens fibres. The clinical study showed the lines occurring with spoke cataract and the electron microscopy showed the association with the novel finding of peripheral breaks in the fibres. A new name 'Fibre Folds' is proposed.