Goodbye Surgery? Scientists Just Made Eye Drops that Dissolve Cataracts

Vision is an essential sense that many people take for granted, seamlessly integrating it into their daily routines for reading, writing, driving, and countless other tasks. However, for millions of individuals worldwide, the ability to see clearly is a significant challenge. This article delves deeply into the prevalence, causes, treatment options, and future directions in addressing cataracts, a leading cause of blindness.

Global Prevalence of Vision Problems
Vision impairment is a widespread issue affecting over 285 million people globally. According to the Fred Hollows Foundation, an estimated 32.4 million individuals are blind, and a staggering 90% of these cases occur in developing countries. Cataracts, characterized by the clouding of the eye's lens, are the leading cause of blindness worldwide, accounting for more than half of these cases. This condition not only affects the quality of life but also imposes a significant socioeconomic burden, particularly in regions with limited access to medical care.

Cataracts: A Closer Look
Cataracts develop when the proteins in the eye's lens undergo structural changes, leading to the formation of cloudy areas that obstruct vision. While the exact mechanisms behind these changes are not entirely understood, Several risk factors have been identified:

1. Age: According to the American Academy of Ophthalmology, nearly 22 million Americans who are over age 40 have cataracts. By the time they reach 80, more than half of all Americans will have cataracts, and many will have to undergo painful and expensive surgery or suffer severe vision problems.
   
   
2. Genetics: Family history plays a role, suggesting a genetic predisposition to the condition.
   
   
3. Environmental Factors: Prolonged exposure to ultraviolet (UV) radiation, smoking, and excessive alcohol consumption can increase the risk of developing cataracts.
   
   
4. Medical Conditions: Diabetes and hypertension are associated with a higher risk of cataracts. Additionally, certain medications, such as corticosteroids, can contribute to cataract formation.
   

Socioeconomic Impact
The impact of cataracts extends beyond individual health, affecting economic productivity and quality of life. In developing countries, where healthcare infrastructure is often inadequate, the economic burden is particularly pronounced. Individuals with untreated cataracts are less able to work, contributing to a cycle of poverty. Moreover, the cost of surgery, the only definitive treatment for cataracts, is prohibitively high for many people in these regions. As a result, millions remain blind due to the lack of access to affordable and effective treatment.

Current Treatment Modalities
Surgical Intervention
Surgery is currently the primary treatment for cataracts and involves the removal of the cloudy lens, which is then replaced with an artificial intraocular lens (IOL). There are several types of cataract surgeries:

1. Phacoemulsification: This is the most common technique, where ultrasonic waves are used to break up the cloudy lens, which is then removed through a small incision. The procedure is quick, minimally invasive, and has a high success rate.
   
   
2. Extracapsular Cataract Extraction (ECCE): In this method, the lens is removed in one piece through a larger incision. This technique is typically used in cases where the cataract is too dense for phacoemulsification.
   
   
3. Intracapsular Cataract Extraction (ICCE): This older technique involves removing the entire lens along with the surrounding capsule. It is rarely used today due to the higher risk of complications.
   

Challenges of Surgical Treatment
While cataract surgery is highly effective, it is not without challenges. The cost of surgery, especially in developing countries, can be prohibitive. Additionally, there are risks associated with any surgical procedure, including infection, bleeding, and retinal detachment. Post-operative care is crucial, and the lack of follow-up services in many regions further complicates the management of cataracts.

Innovative Non-Surgical Treatments
In recent years, researchers have been exploring non-surgical alternatives for cataract treatment. One promising development is the creation of a drug that can be administered via eye drops to dissolve cataracts.

The Lanosterol Eye Drop
A team of researchers in the United States has developed an eye drop formulation based on lanosterol, a naturally occurring steroid. This breakthrough came after the discovery of two siblings who had cataracts due to a genetic mutation that inhibited the production of lanosterol, whereas their parents, who did not have the mutation, were cataract-free. This led scientists to hypothesize that lanosterol plays a crucial role in maintaining the clarity of the lens by preventing the aggregation of crystallin proteins.

In preclinical studies, lanosterol eye drops were administered to rabbits and dogs with cataracts. The results were remarkable, with significant improvement observed within a week. Most test subjects showed a reduction from severe to mild cataracts, and in some cases, the cataracts were completely dissolved.

Mechanism of Action
Lanosterol appears to work by restoring the normal structure of crystallin proteins in the lens, preventing them from clumping together and forming the cloudy areas characteristic of cataracts. This innovative approach targets the root cause of cataract formation, offering a potential non-surgical treatment option that could be more accessible and affordable, especially in resource-limited settings.

Future Directions and Clinical Trials
Despite the promising results in animal studies, lanosterol eye drops have yet to undergo clinical trials in humans. The process of translating preclinical findings to human treatments involves rigorous testing to ensure safety and efficacy. Clinical trials are necessary to determine the appropriate dosage, delivery method, and long-term effects of the treatment.

The regulatory pathway for new drugs is stringent, designed to prevent adverse side effects and ensure that the benefits outweigh the risks. While this means it will be some time before lanosterol eye drops are available on the market, the potential impact on global eye health is immense.

The Role of Healthcare Professionals
Healthcare professionals play a critical role in the early detection and management of cataracts. Regular eye examinations, particularly for individuals over the age of 40, are essential for timely diagnosis and intervention. Educating patients about the risk factors and symptoms of cataracts can promote early treatment, improving outcomes and quality of life.

Patient Education and Advocacy
Patient education is a cornerstone of effective healthcare. Informing patients about the symptoms of cataracts—such as blurred vision, difficulty with night vision, sensitivity to light, and seeing halos around lights—can lead to earlier detection and treatment. Additionally, patients should be aware of the importance of regular eye exams and the potential risks associated with delaying treatment.

Advocacy efforts are also crucial in addressing the global burden of cataracts. Organizations like the Fred Hollows Foundation and the American Academy of Ophthalmology work to raise awareness, provide funding for research, and improve access to eye care services, particularly in underserved regions.

Conclusion
Cataracts remain a leading cause of blindness worldwide, with significant implications for individual health and global socioeconomic development. While surgery is currently the only definitive treatment, innovative research into non-surgical options like lanosterol eye drops offers hope for a more accessible and affordable solution. Continued research, clinical trials, and advocacy are essential to bringing these new treatments to market and improving the lives of millions affected by cataracts.

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Firstly,the reason why the proteins clumps is due to exposure to heat and radiation (unless in cases of hereditary).
Here in Nigeria,there was a case study done statistically to categorize the sex and profession of those exposed to it.and it was mostly women and drivers.

 

This would take a lot of time .. till then minmal invasive surgery, fentosecond laser cataract surgery will go ahead and make life easier

 

Makes logical scientific sense. I hope the FDC speeds up the process of bringing in this product to the market.

 

I am able to recruit volunteers in Bangladesh for clinical trial of your new product that dissolves cataracts. Thanks.

 

This is impressive and good news, i have been implementing eye care community outreach in remote areas in Marsabit County northern part of Kenya. I have interacted with several cataract cases old and young patients who are blind but far flagged referal point that is costly.

 

Jus a quick question does the eye drops clear up a cloudy cornea which has been rejected after sugery

 

Hello doctor my. Dad was eye problem they not clearly see. His eyes in whight liner hear doctor said we want to operation for him and that's clear his eyes .

 

Hello
I can help in testing on human in India.
please contact me +918287740794
Infact My father is also suffering from Catarat and soon he will go for surgery who is 66 years old
If I can get the medicine I can save my father from the pain of surgery,

 

Hi Doc
I am in Cape Town, South Africa.... Suffering from Cataracts as well.... how can I get hold of this.... Email me nizam at arch-tech.za.net (change the @ sign)

 

I can attest heat exposure to be one problem,,,
It was a very cold night and i was laying under the blankets with a small blow heater towards my face... the following few weeks my eyesight deteriorated at such rapid pace, i had to surgically have cataracts removed... ever since, my other eye was also affected... November 2019 coming will be a year since operation... even though the site is much better, i still Marjory have discomfort in the operated eye.... probably because i am diabetic as well

 

Hi Doc
I'm in Monrovia, Liberia. There are thousands suffering from cataracts here. Wish to be a part in saving life if you could extend your services here, and considering my email as contact...

 

If something does come up for topical use to treat cataract, it will certainly be great. But till then simple eye surgery by way of phakoemulsification whereby the natural opacified lens is replaced with an artificial intraocular lens (IOL) is the accepted choice. And the good news is that the surgery doesn't cost a fortune even in a developing country like India, especially in Government hospitals and centres managed by NGOs. And medical insurance policies generally take care of expenses at private clinics as well. Another point that needs to be emphasised is that cataract can now be operated upon in any stage...when its development starts interfering with the normal day-to-day activities of an individual, and it's unwise to wait for it to get ripened as is shown in this picture! - Editor, Optometry Today, Ophthacare Eye Centre, Janakpuri, New Delhi

 

India has had a treatment for treating cataract without surgery for hundreds, if not 1000s of years old. Villagers still use it. If americans "found" a treatment, it must be stolen knowledge just like they stole Sarpacil, ginger, Turmeric etc

 

Since cataract is the commonest cause of curable blindness across the universe, the process of clinical trials of the supposedly breakthrough topical-use medication on human beings needs to be expedited - Editor, Optometry Today

 

I think it should be pointed out - the video this post is based on, was published in 2016. This year (2019), the doctor involved in this project, Kang Zhang, is being investigated for placing patients in harm's way - plus his cure has either progressed in the last 3 years or it's stalled. Either way - this is not the post to rely on for an up to date look at this project. There have been no updates in the media on this project for the last 3 years - hardly what you'd expect to see in a promising project that's being funded. He quit USCD where he was leading this project in August - https://www.the-scientist.com/news-...fter-investigation-into-ties-with-china-66344.

Posts about Kang Zhang's alleged issues with patient trials can be found at https://inewsource.org/2019/04/23/u...HsVVSFDlfZVhnxp0HgmVQIyOXKclbDZD8ecNIMDhIHp3I, https://timesofsandiego.com/tech/2019/04/24/ucsd-doctor-kang-zhang-violated-human-research-rules/,

Fake news starts with us and posts like this with snappy headlines. The background was available - don't just take what you see at face value.

 

I would love to offer our dog as a trial of the drops. We have an 8 year old pedigree Cocker Spaniel, ex- show dog (so we rescued her.) she is almost totally blind and has cataracts in both eyes. We would be willing to try the drops on her as sadly the cost of surgery is prohibitive but as a small dog in otherwise excellent health she will Probably be expected to live another 8-10 years.

 

@The Librarian,

The news stories were simply allegations which were never proven and no action was taken by the medical board because the care that was provided was within the standard of care and there was no malpractice. Looking at what happened at other research universities such as MDAnderson, Emory, etc with Chinese researchers, it seems he was targeted because of his ethnicity.

https://time.com/5596066/emory-fires-chinese-researchers/
https://www.houstonchronicle.com/ne...fires-3-scientists-over-concerns-13780570.php

I guess it's too much to ask someone to think about things outside of what is presented. These drops are going to make a huge shift in patient care especially in areas with shortages of Ophthalmologists.

 

We had a patient just ask about this. Due to increased oxidative stress from the drops it can aggravate conditions such as age related macular degeneration. Plus it had failed to meet its endpoint goals in more than one clinical study. One theory is they can prevent the development of cataracts over time when started at a young age but then you worry about the life long side effects of using the medication over a period of decades.

https://www.nature.com/articles/s41598-019-44676-4.pdf

https://www.sciencedirect.com/science/article/pii/S2213231712000079

https://reader.elsevier.com/reader/...937B37B41F8FCC7C7A33708D67913E944E54C2993987A