Cataracts: Are There Any Alternative Treatments to Surgery?

What are cataracts?

A Cataract is an ophthalmological disorder that causes clouding of the usually clear lens of the eye, resulting in impaired vision and decreased visual acuity. The lens is the transparent part of the eye responsible for focusing the light and forming images on the light-sensitive membrane in the eye called the retina.

Cataract

Cataract. Image Courtesy of Rakesh Ahuja, MD

Cataract development is a slowly progressing condition and doesn’t affect the vision much in the beginning. Over time, however, it affects more and more of the lens, resulting in a denser clouding of the lens. This vision impairment can easily be dealt with using strong lighting and prescription eyeglasses.

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Eventually though, as cataracts cover more area of the lens, they prevent light from passing through and do not allow for a clear image to form on the retina. This causes blurred and foggy vision that can seriously impair the affected person’s ability to perform daily functions.

It is almost important to note that cataracts don’t necessarily develop in both eyes at the same time. Vision in one eye may be more severely impaired than in the other eye.

What are the risk factors for Cataract Development?

Most cataracts develop as a result of the aging process, but can also occur due to other risk factors like:

  • Diabetes
  • Excessive exposure to sunlight
  • Smoking
  • Obesity
  • Hypertension
  • Previous eye injury or inflammation
  • Previous eye surgery
  • Prolonged use of corticosteroid medications
  • Excessive alcohol consumption

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How are cataracts diagnosed?

Cataracts are suspected based on clinical symptoms and the personal history of the patient. When a physician suspects the diagnosis of cataracts, they can confirm the diagnosis using an eye examination. Some of the tests they may perform include:

  • Visual Acuity Test: This is a non-invasive, simple test that can be performed in the doctor’s office. The patient is required to read off a chart from a distance while covering one eye and repeat the process for the other eye. This test can help determine if the patient has a 20/20 vision or if they have impaired vision.
  • Slit-lamp Examination: In this type of examination, the doctor uses a microscope and a strong line of light to examine the internal eye structures. Any defect, even the smallest one, in the iris, cornea, lens, and space between cornea and iris will be visible to the doctor in this examination.
  • Retinal Exam (ophthalmoscopy/fundoscopy): In this type of examination, the doctor first needs to make the eyes dilate, using eye drops. After that, the physician might use an ophthalmoscope or a slit-lamp microscope to view the lens properly.

Is there a treatment for cataracts?

Cataract management in the earliest phase of cataract development includes the use of prescription glasses and better lighting sources. However, once it has progressed to almost complete clouding of the lens, the use of glasses doesn’t help much. In that case, cataract surgery is needed.

Once cataracts start to affect a person’s ability to perform daily functions, surgical intervention should be considered. Cataract surgery is an outpatient procedure, meaning that the patient does not need to stay in the hospital after the surgery.

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The surgery involves the use of a local anesthetic to numb the eye but the patient is generally awake during the surgery. Like any other medical procedure, cataract surgery carries risks of certain complications such as infection, retinal detachment, inflammation inside the eye, swelling in certain parts of the eye, retention of a piece of the cataract inside the eye, glaucoma, hemorrhage (bleeding), possible worsening of certain eye conditions (such as diabetic retinopathy).

However, it is important to note that only 1 percent of cataract surgeries result in these complications.

Are there non-surgical treatments for cataracts?

Most people try to avoid surgical procedures at any cost, and understandably so. Due to this, many research studies have been performed with the objective of finding a non-surgical cure for cataracts. However, no complete cure has been found so far.

1. Sterol containing Eye Drops

In a study performed on animal models by Jason Gestwicki from the University of California at San Francisco (UCSF), the research team found that the use of eye drops containing the molecule; sterol, which has the ability to bind and re-solubilize misfolded proteins in the eye, resulted in increased transparency of the lens and decreased clouding in the animal models.

Gestwicki also applied these drops to isolated human eye lenses with cataracts and found promising results. According to him, “We did see very promising improvements in transparency and protein solubility in the lens, although not a complete reversal”.

However, these eye drops may not be able to reverse late-stage cataracts and even if they do, more research needs to be done to test their abilities and determine their toxic and safe levels. It is important to note that this treatment option is not FDA-approved and is still in the experimental stage.

Read Also: Blindness: Reactivating Inactive Genes Can Regenerate Damaged Retinas

2. N-acetyl carnosine Eye drops

The use of N-acetyl carnosine to penetrate the cornea to prevent or reverse cataract progression has been theorized in the literature several times. However, it is a theoretical concept, a mere hypothesis that needs to be confirmed with further studies and research.

Many studies are underway to try and develop a non-surgical treatment for cataracts however, it is going to be a long time before one is approved and declared efficient.

Cataracts severely impair one’s ability to perform daily functions and can reduce the affected person’s quality of life significantly. Apart from surgery, there is no treatment for cataracts. Furthermore, cataracts cannot be prevented or reversed without surgery. But there are certain healthy life choices that may help make an earlier diagnosis or decrease the risk of cataract development, such as:

  • Have regular eye examinations: This is a great option for not just earlier diagnosis of cataracts, but also other ophthalmological conditions
  • Quit smoking
  • Decreased alcohol consumption
  • Management of medical conditions like Diabetes Mellitus: Patients with DM may experience faster progression of cataracts compared to non-diabetic patients
  • A healthier and balanced diet containing vitamin-rich fruits and vegetables
  • Wear sunglasses

Read Also: An Artificial Retina to Restore Sight Could Soon Become a Reality

References

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts

https://www.scientificamerican.com/article/eye-drops-show-promise-in-treating-cataracts-without-surgery/

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