Richard’s View: Cataract Research

There have been some interesting developments in the field of cataract research published in the last month or two. The most optimistic interpretation suggests that in a few years’ time (who knows how many?) eye drops will be available that will magically reduce or even eliminate all the cloudiness that goes to make life with cataracts so difficult. The opposite point of view – the most pessimistic interpretation – is that they will prove to be yet another bright idea that turns out to be useless.

I say magically – that’s a bit unfair on a piece of really interesting research. What happened, apparently, is that during another piece of work on patients with congenital cataract the researchers noticed a similar genetic abnormality that gave rise to a lack of lanesterol, a naturally occurring steroid, in the patients being studied. Where a child had the genetic mutation that stopped the production of lanesterol they would develop cataracts but their parents who didn’t have the mutation (and consequently did produce lanesterol) didn’t develop them.

They went on to try and see what effect lanesterol had on human lens cells that had cataracts – and found that it significantly reduced them. Then they moved on to trying the drops on rabbits. At the end of six days of treatment 11 of 13 rabbits that had cataract originally had shown significant reduction in their cataract or even complete elimination of it. Finally they treated a group of seven dogs – of different breeds but all already naturally affected by cataract – and found that the results were just as good whether the lanesterol was given by injection or as drops.

As yet the exact mechanism by which the lanesterol works has not been discovered (or at least has not yet been published) so it is a little early to hope for clinical trials on humans but just think of the possible benefits this treatment might provide. Quite apart from giving every older patient clearer sight, cataract surgery is the most frequently performed surgical procedure in the UK so there would be a huge reduction in the pressure on eye clinics and consequently much more time (and money) available for other ophthalmic treatments.

One unwelcome side effect could be the loss of widespread skill in cataract removal for the cases that would undoubtedly remain and for the cases where high degrees of short or long sight are currently treated by a form of cataract surgery.

It’s all in the future, but for now people in far off countries with much poorer access to eye care are still benefitting from your donations of old spectacles to VAO – please keep bringing them in.

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