In the future, doctors might be able to treat or prevent cataracts with eyedrops – all because of an unexpected discovery, revealed during a genetics study, about a molecule that helps make cholesterol in human cells. Most of us will live long enough to develop cataracts – rare in the under 50’s but very common in 70+ year olds. At the moment the only approved treatment for cataract is surgical removal and (usually) replacement of the cloudy lens with a new clear plastic one.

Researchers found that when studying the genetics of two families who all had congenital cataract (they were born with them) that they had an inability to produce a chemical called lanosterol, which is required in the chemical cycle of cholesterol production. The researchers found that lanosterol significantly reduced the protein aggregation in the lens of the eye which in turn reduced the production of incorrect proteins in the lens. The lens is made of fibres composed of proteins called crystallines, and cataract will occur if these become damaged or changed, or begin to be made incorrectly.

Adding lanosterol to crystalline lenses which had been surgically removed significantly reduced that amount of cataract, and they have found similar success in treating the lenses inside the eyes of (so far) rabbits and dogs.

The results so far look good, and because lanosterol is produced naturally in the body, they are hopeful that human clinical trial may only be a few years away. There may still be issues to overcome – the lens is behind the iris – fairly deep into the eye, and surrounded by the lens capsule, which could be a barrier to getting enough active ingredient into the lens itself. If it worked, but needed 10 drops per eye per day….

If the drops were safe, even if they did not completely fix the cataracts, if it allowed postponement of surgery for a while longer, that in itself would be a success – no surgery is risk free, though cataract surgery is among the most successful and commonly performed operation in the western world – perhaps the world over. They may also be cheaper than surgical intervention, but there can be issues with patients having difficulty putting in eye drops, either because they can’t do it, or can’t be bothered, or forget.

There are already eye drops available which  ARE CLAIMED to be able to reduce and repair cataracts – these drops contain N-acetylcarnosine (NAC), which is not approved by the FDA as a cataract treatment. These drops might work, but if they do, why have they not been submitted to the relevant regulator authorities in the US and Europe to prove their safety and success? As you could read here, it is apparently all because of the corrupt FDA, Ophthalmologists and Optometrists! Or perhaps it is because they don’t work?

(If you did read that article, Optometrists in Ireland get paid nothing extra to refer a patient with cataracts – there are no “Kick-backs” or co-management fees in Ireland)

These new lanosterol drops are only at the research stage for the moment, but the scientists are confident that they have, by chance, found an effective medical treatment for cataracts.

You could read the article published in the journal Nature here, but it will cost you £22, and I would suggest it is best left to genetics researchers to read!