Age-stratified normative lens densitometry in children: zone-specific reference curves from 4–18 years

CLINICAL RELEVANCE: Quantitative evaluation of lens transparency may aid the clinical assessment of normal and abnormal lenticular changes during childhood. BACKGROUND: Scheimpflug imaging enables objective measurement of crystalline lens light backscatter. While age-related increases in lens densitometry are well documented in adults, normative paediatric data remain limited. Because lens development in childhood differs fundamentally from adult cataractogenesis, age-stratified reference standards are required. METHODS: This cross-sectional study included 188 eyes from 188 participants aged 4-18 years. Scheimpflug imaging (Pentacam HR) was used to measure global and zone-specific lens densitometry (nucleus 0-2 mm, anterior cortex, posterior cortex, annulus 2-4 mm, annulus 4-6 mm). Demographic and biometric parameters, including visual acuity, refraction, keratometry, anterior chamber depth, lens thickness, and pupil diameter, were recorded. RESULTS: < 0.001 for both). CONCLUSIONS: Lens density decreases across childhood, most markedly in the nucleus, reflecting physiologic maturation.