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Researchers in the US have developed a new drug that can be

delivered directly into the eye via an eye dropper to shrink down and
dissolve cataracts - the leading cause of blindness in humans.
While the effects have yet to be tested on humans, the team from the
University of California, San Diego hopes to replicate the findings in
clinical trials and offer an alternative to the only treatment thats
currently available to cataract patients - painful and often prohibitively
expensive surgery.
Affecting tens of millions of people worldwide, cataracts cause the lens
of the eye to become progressively cloudy, and when left untreated,
can lead to total blindness. This occurs when the structure of the
crystallin proteins that make up the lens in our eyes deteriorates,
causing the damaged or disorganised proteins to clump and form a
milky blue or brown layer. While cataracts cannot spread from one eye
to the other, they can occur independently in both eyes.
Scientists arent entirely sure what cases cataracts, but most cases are
related to age, with the US National Eye Institute reporting that by the
age of 80, more than half of all Americans either have a cataract, or
have had cataract surgery. While unpleasant, the surgical procedure to
remove a cataract is very simple and safe, but many communities in
developing countries and regional areas do not have access to the
money or facilities to perform it, which means blindness is inevitable for
the vast majority of patients.
According to the Fred Hollows Foundation, an estimated 32.4 million
people around the world today are blind, and 90 percent of them live in
developing countries. More than half of these cases were caused by
cataracts, which means having an eye drop as an alternative to surgery
would make an incredible difference.

The new drug is based on a naturally-occurring steroid called

lanosterol. The idea to test the effectiveness of lanosterol on cataracts
came to the researchers when they became aware of two children in
China who had inherited a congenital form of cataract, which had never
affected their parents. The researchers discovered that these siblings
shared a mutation that stopped the production of lanosterol, which their
parents lacked.
So if the parents were producing lanosterol and didnt get cataracts, but
their children werent producing lanosterol and did get cataracts, the
researchers proposed that the steroid might halt the defective crystallin
proteins from clumping together and forming cataracts in the noncongenital form of the disease.
They tested their lanosterol-based eye drops in three types of
experiments. They worked with human lens in the lab and saw a
decrease in cataract size. They then tested the effects on rabbits, and
according to Hanae Armitage at Science Mag, after six days, all but
two of their 13 patients had gone from having severe cataracts to mild
cataracts or no cataracts at all. Finally, they tested the eye drops on
dogs with naturally occurring cataracts. Just like the human lens in the
lab and the rabbits, the dogs responded positively to the drug, with
severe cataracts shrinking away to nothing, or almost nothing.
The results have been published in Nature.
"This is a really comprehensive and compelling paper - the strongest
Ive seen of its kind in a decade," molecular biologist Jonathan King
from the Massachusetts Institute of Technology (MIT) told Armitage.
While not affiliated with this study, King has been involved in cataract
research for the past 15 years. "They discovered the phenomena and
then followed with all of the experiments that you should do - thats as
biologically relevant as you can get."

The next step is for the researchers to figure out exactly how the
lanosterol-based eye drops are eliciting this response from the cataract
proteins, and to progress their research to human trials.