Histopathology and surgical approach in cataract associated with true exfoliation of the lens capsule

True exfoliation is a delamination of the superficial layer of anterior lens capsule, which appears as a transparent membrane in the anterior chamber. It is a rare occurrence, and most of the reported cases have been associated with a history of exposure to excessive heat, ocular trauma, or inflammation. We report pre- and post-operative anterior segment observations, surgical approach and histopathology of the excised lens capsule in a patient who presented with bilateral true exfoliation without any contributory history. This case highlights findings from light microscopy which demonstrated a lamellar separation of the anterior lens capsule and partial detachment of anterior capsule with reduced intensity of periodic acid Schiff's staining in the detached portion, confirming the diagnosis of true exfoliation.