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In lens cataract, the clouding change in lens leads to a decline oftransparency of part of the lens. There are three types of senile cataract:cortical cataract, nuclear cataract, and posterior/anterior sub-capsularcataract. The most common senile cataract is cortical cataract. Forunderstanding cortical cataract, the pathology and the causing factors incortical cataract are analyzed. The clouding change in senile cortical cataractbegins from the edge of the lens and develops progressively to lens centre. Thepathology of clouding change in cortical cataract is characterized bydisruption of some lens fibers, swelling of some other fibers, and depositionof water between fibers. Based on the property of a lens fiber, we propose herea hypothesis on the mechanism of development of senile cortical cataract. I.Cortical cataract is triggered by disruption of a cortical lens fiber as aresult of injury. The disrupted fiber will release water and crystallinproteins. II. Neighbor fibers can absorb this water due to high intracellularosmotic pressure (IOP) and become swollen. Swelling makes a fiber be stiff andhave increased risk to disrupt when it is curved during the accommodation ofthe lens. These fibers will release water again when they disrupt, and thewater will make more local fibers swelling. In this way, the local fibersbecome swollen and then disrupt successively. III. The successive swellings anddisruptions of local fibers result in enlargement of a clouding change in lens.Since the fibers on the outer part of lens cortex have higher risk to beinjured than that in the inner part, a clouding change starts from the edge ofthe lens. In conclusion, the progressive development of senile corticalcataract is a result of successive swellings and disruptions of local lensfibers, and this is driven by the high IOP in a lens fiber.

The high osmotic pressure in a lens fiber as a driving force for the development of senile cortical cataract