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November 1969

True Exfoliation of the Lens Capsule: An Electron Microscopic Study

Author Affiliations

St. Louis
From the Department of Ophthalmology and the Oscar Johnson Institute, Washington University School of Medicine, St. Louis.

Arch Ophthalmol. 1969;82(5):651-653. doi:10.1001/archopht.1969.00990020647013

THE CLASSIC paper of Theobald1 in 1954 recognized and identified the two different clinical and pathologic entities of true and pseudoexfoliation of the lens capsule. Until this time, the ophthalmic literature was replete with case reports grouping the genetically inherited pseudoexfoliation and the occupationally induced true exfoliation of the lens capsule as a single entity. True exfoliation of the lens capsule was originally described clinically by Elschnig2 in three glassblowers in 1922. In 1929, Vogt3 presented a histopathologic study of a man with an occupational exposure to intense heat who clinically demonstrated this phenomenon.

Theobald, in separating the two entities, described the characteristic clinical picture of "true" exfoliation as that of a thin glasslike membrane peeling off of the lens capsule in the pupillary zone. She emphasized the association of this finding with occupational exposure to intense heat. The other type of exfoliation which she called "pseudoexfoliation"