Cortical cataract development--an expression of primary damage to the lens epithelium

Inasmuch as cortical opacities constitute the majority of senile cataracts their pathogenesis has been a matter of investigative concern for over a century. Evidence has been accumulating indicating a primary role for the lens epithelium in the loss of transparency of the cortex. Data from experimental work and clinical experience are consistent with a primary damage to the genome of the lens epithelial cell. The damage is mediated by the aberrant differentiation of lens fiber cells which collectively express as a cataract. The present paper reviews some of that evidence and offers preliminary analysis of the contributing aspects of cellular parameters associated with the pathology. Also, the concept of the "cataractotoxic load" and its applicability to the development of human senile cortical cataracts is discussed.