A Revolution in Cataract Treatment
Medicine has been proving to us time and time again that new treatment options which are less painful and more efficient are being uncovered. New treatment options that can almost replace conventional methods of treatment can prove as a boon to change the lives of those suffering from diseases that can vary in severity. One of the most common conditions among seniors in our society and since the dawn of humanity are cataracts. Researchers are now working on creating eye drops that can create paths for a non surgical method of treating cataracts. So, in simpler words a revolution in the cataract treatment is going to take place when the drops are approved by the FDA for patient use. The fact that half of Americans by the age of 80 have either had cataract surgery or are currently suffering from cataracts can even justify that there is going to be a revolution in the geriatric care.
So what are cataracts exactly? Cataracts are caused by proteins called amyloids that eventually lump in multiple layers on eye lens over a long period of time. This causes the common complaints about fuzzy or blurry vision which can bar many cataract patients from day to day activities such as driving. In fact, leaving this condition untreated is reported to cause blindness as the amyloids pile up in ever larger amounts on the eye lens. Therefore, it is recommended that cataracts should be treated as soon as possible to prevent expensive medical surgeries. Please look at the image below to get a better idea of where cataracts form.
So, why do the amyloid proteins pile up in multiple layers on the surface of the eye over time? To answer that question we must look at the surface interactions between amyloid proteins and another structural protein commonly present in retina and the eye lens called crystallins. We must also take into consideration the solubility level of both these proteins in order to understand why cataracts are formed. The crystallins are water soluble structural proteins which reduce the buildup of non-soluble amyloid proteins in the eye by the enactment of several chemical and biological proccesses. This function is carried out effectively for several decades but eventually the functioning ability of the crystallins decrease which will in turn increase the buildup of amyloids in the eye lens. Therefore, the eye drops should be composed of a compound that is soluble in water and would prevent further buildup of amyloids and at the same time also remove current buildup of it.
Scientists in fact, bumped on a compound called Lanosterol which is part of the group of chemical compounds called sterols. Sterols such as lanosterol were told to decrease cataracts according to previous scientific research. However, lanosterol is not water soluble which will cause more blurry vision which will lead it to accumulate on the eye lens in layers just like amyloids and would further overwhelm the crystallins. So, the search for a sterol that is water soluble and is able to prevent further buildup and reduce current buildup of amyloids had been initiated.
A new study was conducted where researchers would test different sterols in a petri dish with amyloids and on mice that suffered from hereditary cataracts. Eventually they found a sterol called 25-hydroxycholesterol which was found to effectively dissolve amyloids. To accurately differ between whether this compound actually works in the eye lens of a mouse the left eye was left untreated and therefore could be referred to as a control group. The right eye was used as the experimental group where the sterol would be injected. After around 4 weeks of treatment the researchers concluded that there was a 1 grade improvement in cataract severity in the right eye, on the other hand the control group showed no improvement. Comparing the control and experimental group was essential to determine whether the eyes showed any visual cues that the cataracts had been reduced.
However, there are certain limitations to this research even though it can form as a baseline for more scientific research about this treatment method. The main problem with this study is that it was conducted on mice. Unfortunately, mice can't explain the improvements in vision like patients can explain to their doctors. Therefore, we really can't quantify how much improvement cataract patients will experience when they use this. In fact, even if we decide to create an experimental study where one group gets a placebo and the other gets the eye drops the variability in responses of patients who got the drops will be huge. Therefore, evaluating the responses itself will prove to be a monumental task. Another problem with creating this type of experimental study is the violation of the Hippocratic oath which ensures that the doctor will treat the patient for his/her condition as soon as it is reported. Therefore, it would be a disservice to those who are receiving the placebo because they are not treated for their condition immediately.
Right now, your hopes about these drops being approved by the FDA for public use would have been shattered, but fear not because there is always a solution to a problem. Science usually presents a lot of hurdles to its fellow researchers during research, but over time they will cross those hurdles and reach the appropriate conclusion which in this case can be either affirmative or negative. Of course, in this case we should be optimistic that the result is affirmative so that future generations that will face cataracts and current generations that are facing cataracts can provide a better treatment option which will revolutionize the age old treatment method of eye surgery for the removal of cataracts.
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