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Ophthalmic Images

Beware of the ominous folds

Balijepalli, Pasyanthi; Srirampur, Arjun1

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Indian Journal of Ophthalmology: October 2020 - Volume 68 - Issue 10 - p 2256
doi: 10.4103/ijo.IJO_238_20
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A 73-year-old man presented with Pseudoexfoliation cataract in his right eye. Nuclear sclerosis grade 2 with posterior subcapsular opacity (PSC) was noted with pseudoexfoliation material on the anterior lens capsule. Interestingly, the posterior capsule showed radiating folds superior and inferior to the PSC, seen during retro illumination [Fig. 1]. During phacoemulsification, zonular weakness was noted. It is well known that posterior capsular folds can occur during cataract surgery due to lack of zonular stretch in cases with zonular weakness.[1] A diligent preoperative slit lamp evaluation can also identify such folds on the posterior capsule, which helps to prevent intraoperative complications like zonular dialysis.

Figure 1:
Retro illumination photograph showing radiating folds on the posterior capsule superior and inferior to the posterior subcapsular opacity

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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.


1. Mansour AM, Antonios RS, Ahmed II. Central cortical cleanup and zonular deficiency ClinOphthalmol (Auckland, NZ). 2016;10:1919–23
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