Cambridge Ophthalmological Symposium
Eye (2005) 19, 1074–1082. doi:10.1038/sj.eye.6701964
External factors in the development of cataract
1Centre for Eye Research Australia, University of Melbourne, East Melbourne, Australia
Correspondence: L Robman, Centre for Eye Research Australia, The University of Melbourne, 32 Gisborne St, East Melbourne 3002, Australia. Tel: +613 9929 8360; Fax: +613 9662 3859. E-mail: liubov@unimelb.edu.au
Received 14 April 2005; Accepted 2 May 2005.
Abstract
Aims
To provide an update on the risk factors for cataract development.
Methods
Review of the literature.
Results
Age and heredity are the most important risk factors associated with the different types of cataract. While the hereditary component is self-explanatory, increasing age serves as a surrogate for a number of potential external risk factors, the effect of which is cumulative. Identification of the risk factors that have a causal effect on cataract development may provide means for cataract prevention. There are only a few risk factors that satisfy the criteria for causal effect: smoking, which results in the increased risk of nuclear cataract, excessive UV-B exposure and diabetes that increase the risk of cortical cataract, and steroidal treatment, diabetes and ionising radiation that lead to the formation of posterior subcapsular opacity. The effect of medications on cataract development requires further study, since the effect of the diseases should be distinguished from that of treatment. 'Stop Smoking' and 'UV-B protection' campaigns are gaining momentum as preventative measures, while the attempts to actively prevent cataract with antioxidants have not been successful. Cataract research has been facilitated lately by improvements of precision and standardisation in measuring lens opacities. However, measurement precision on its own cannot give us a solution to this problem.
Conclusion
The major studies repeatedly measure the exposure to the traditional health hazards, while the missing parts in the equation are those risk factors that we do not know about and therefore do not measure. New approaches and new hypotheses are needed.
Keywords:
cataract, risk factors, causal associations
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