Can cataract be prevented?

The feasibility of preventing cataract by elimination of risk factors or by anti-cataract therapy is reviewed. Elimination of the major risk factors in Western countries would be difficult, although it has potential in the developing world. Various approaches to drug therapy have been made but ran into problems. The development of aldose reductase inhibitors received by far the greatest financial support but problems with toxicity were rapidly followed by the collapse of the original hypothesis. The case of aspirin, paracetamol and ibuprofen built up more slowly with no encouragement from the pharmaceutical industry. Positive results have been achieved in vitro, and in the prevention of diabetic cataract in rats, as well as the identification of an association with a protective effect against cataract in human patients. A clinical trial of these compounds is required. Other anti-cataract agents are also being investigated.