Are there any medications to treat cataracts?

No Medications Are Currently Available to Treat Cataracts

There are currently no pharmacological treatments known to eliminate existing cataracts or retard their progression. 1 Surgical removal of the affected lens remains the gold standard and only proven treatment for cataracts.

Current Evidence on Medical Management

Lack of Effective Medications

• The American Academy of Ophthalmology's Preferred Practice Pattern (2022) clearly states that no pharmacological treatments are known to eliminate existing cataracts or slow their progression 1
• A 2017 Cochrane Systematic Review of N-acetylcarnosine drops found insufficient evidence to support their use for cataract treatment 1
• Despite ongoing research into various therapeutic agents and formulation strategies, no pharmaceutical treatment for prevention or cure of cataracts has been approved 2

Attempted Pharmacological Approaches (All Unsuccessful)

Previous research has investigated several potential medication classes:

• Sorbitol-lowering agents (aldose reductase inhibitors): Initially studied based on the sorbitol hypothesis for diabetic cataract, but clinical trials were disappointing 3
• Anti-inflammatory medications: Aspirin, paracetamol, and ibuprofen showed promise in animal studies and some epidemiological studies, but clinical trials have not been encouraging 4
• Antioxidants and micronutrients: Despite theoretical benefits, clinical evidence is lacking 3, 4
• Carnosine derivatives: Some reached clinical trials with encouraging preliminary results, but insufficient evidence for approval 5

Non-Surgical Management Options

While no medications can treat cataracts, several non-surgical approaches can help manage symptoms before surgery becomes necessary:

• Optical correction: Changes to glasses and contact lens prescriptions can account for refractive shifts in early cataract development 1
• Low-vision devices: These can maximize remaining vision pending surgery or allow surgery to be deferred in high-risk patients 1
• Limited pupil dilation: In specific circumstances, dilating the pupil may provide better vision around a small central cataract (though this may worsen glare) 1

Prevention Strategies

While no medications can treat existing cataracts, several preventive measures may help reduce risk:

• Lifestyle modifications:

  • Smoking cessation (smoking is a dose-dependent risk factor) 1
  • Protection from ultraviolet-B radiation (brimmed hats, UV-blocking sunglasses) 1
  • Physical activity and reduced sedentary time 1
  • Safety glasses for high-risk activities to prevent traumatic cataracts 1

• Dietary considerations:

  • Well-balanced diet rich in fruits and vegetables 1
  • Multivitamin/mineral supplements may decrease risk (moderate evidence) 1
  • No level 1 evidence supports high-dose antioxidant supplementation 1

• Medical condition management:

  • Control of diabetes, hypertension, obesity, and metabolic syndrome 1
  • Consideration of alternative treatments to long-term corticosteroid use when possible 1

Clinical Implications

Ophthalmologists should advise patients that:

1. No medications can currently treat or slow the progression of cataracts
2. Surgery remains the only effective treatment when vision becomes significantly impaired
3. Preventive measures may help delay cataract formation but cannot reverse existing cataracts
4. Regular eye examinations are important for monitoring cataract progression and determining appropriate timing for surgical intervention

Common Pitfalls to Avoid

• Unproven treatments: Patients may seek unproven "cataract-dissolving" eye drops marketed online or in some countries without regulatory approval
• Delayed referral: Waiting too long for surgical evaluation can lead to more difficult surgery and poorer outcomes
• Medication misconceptions: Some patients may incorrectly believe that certain medications (like those for glaucoma) can treat cataracts
• Ignoring modifiable risk factors: Missing opportunities to counsel patients on preventable causes of cataract progression

In conclusion, while research continues into potential pharmacological treatments for cataracts, surgery remains the only proven and effective treatment option at this time.