These eye drops claim to have the same cataract treatment effect as Lanomax because they contain lanosterol but, unfortunately, these claims are not true at all. 3Department of Clinical Pharmacy, Bolzano's Central Public Hospital, Italy The identification of a single point mutation in the IRE of the L-ferritin mRNA in members from a family affected with dominantly inherited hyperferritinaemia and cataract is reported, the first mutation affecting the IRP-IRE interaction and the iron-mediated regulation of ferritin synthesis. BMC Med Genet. The https:// ensures that you are connecting to the Moreau KL, King JA. Conventional treatment for cataracts is eye surgery. Unable to load your collection due to an error, Unable to load your delegates due to an error, Lens opacity grading system1: Grade 0: Gridlines clearly seen; (a) Grade 1: Minimal clouding of gridlines, with gridlines still visible; (b) Grade 2: Moderate clouding of gridlines with main gridlines visible; (c) Grade 3: Total clouding of gridlines with gridlines not seen at all, (a and c) Pre incubation images of lens nuclei in lanosterol and control solution respectively. British Journal Ophthalmology (2011). The Chief of Ophthalmic Genetics and Professor of Ophthalmology, Dr. Kang Zhang, is credited with the commencement of research into lanosterol as an organic compound that can clear cataracts. found that Twenty-five mM lanosterol solution failed to reverse nuclear opacity of human age-related cataractous nuclei after 6 days of incubation [5]. Congenital cataracts and their molecular genetics. 2018 Oct 11;61(19):8693-8706. doi: 10.1021/acs.jmedchem.8b00705. Save my name, email, and website in this browser for the next time I comment. In cataracts we still keep replacing a clouded lens without considering the pathogenetic mechanism of lens clouding, and without helping the lens epithelium to restore its homeostatic functions. Fortune Journals uses best softwares for identifying plagiarism and it never accept articles with higher plagiarism. The number of people. To test that, they grew lens cells with crystallin clumps in a Petri dish. Understanding Nuclear Sclerotic Cataracts. Results of the human testing phase showed enough promise to suggest that it could be the real deal. Lanosterol reverses protein aggregation in cataracts. The same things that can cause humans itchiness, redness or swelling of the eyes can also affect our dogs. All Rights Reserved. Lanosterol The therapeutic effect of Lanomax varies greatly depending on the type of cataract and the degree of its progression. Cataract, defined by abnormal opacification of the intraocular crystalline lens, is the leading cause of blindness in the developing world, affecting millions worldwide 1. Materials and methods: Currently you have JavaScript disabled. However, cataract surgery also corrects changes in vision, such as nearsightedness, which can worsen with cataracts. 8600 Rockville Pike Congenital cataracts and their molecular genetics. Pascolini D, Mariotti SPM. Elife. International Journal of Molecular Sciences. Pre- and post-immersion photographs were graded by two masked observers and collated for the regression or progression of lens opacity. [Step 4] After 9 weeks of treatment, re-evaluate the progress of cataracts at the same veterinary hospital and send us the documents by email. Eyedrops for Cataract Treatment Scientists discovered lanosterol's cataract reducing ability by studying two children who had a genetic condition that caused cataracts at an early age. If approved for human use, the compound would be available as a non-invasive treatment for individuals with . LumenPro is unique in that it is the only lanosterol . Cataracts are usually treated with cataract surgery. (b and d) Post incubation images of the same nuclei after incubation in Lanosterol and control solution for 6 days; respectively, The comparison of means of control and lanosterol groups; before and after the test, showed no statistically significant difference, (a) Pre- and (b) post-incubation images of the lanosterol incubated nucleus graded as regression of lenticular opacity by one observer. In the light of recent scientific findings and considering the lack of studies on humans in this field we tested lanosterol eye drops on a human juvenile nuclear cataract with a lower lanosterol concentration and with a different vehicle compared to the eye drops recently tested on animals. Front Mol Biosci. [5] Heliostatix Biotechnology claims to have a method of solubilizing lanosterol for use in aqueous products. Protein misfolding and aggregation in cataract disease and prospects for prevention. In fact, in the experiments on the seven dogs, Zhang's team had to anesthetize all of dogs and inject the lanosterol solution directly into the vitreous body of the eyes in addition to administering the lanosterol eye drops. Shanmugam PM, Barigali A, Kadaskar J, Borgohain S, Mishra DK, Ramanjulu R, Minija CK. (October 2018). Each 10 mL bottle of LumenPro contains two cataract-fighting ingredients, lanosterol (0.25%) and n-acetylcarnosine (1%). Lanosterol is not an approved treatment for cataracts at this time and is still being studied in experimental settings. Nature. Could eye drops be an alternative treatment to cataract surgery? It may be possible one day to use lanosterol in the form of a topical eye drop to reduce cataract development. doi: 10.1371/journal.pone.0273868. Eur. its not like cataract surgery but with laser. It is already present in the crystalline eye lens as this compound is what helps the lens to maintain its transparency. The team then moved on to dogs, using a group of seven dogs who were suffering from age-related cataracts. (2020, February 21). Copyright 2018 Elsevier Inc. All rights reserved. official website and that any information you provide is encrypted (2020, February 21). Heliostatix is working on additional methods for increasing the effective amount of lanosterol that can be delivered to human cataracts with the goal of creating a non-invasive drug for human cataract removal. In the light of recent scientific findings and considering the lack of studies on humans in this field we tested lanosterol eye drops on a human juvenile nuclear cataract with a lower lanosterol concentration and with a different vehicle compared to the eye drops recently tested on animals. Dr. Kang Zhang, Professor of Ophthalmology and Chief of Ophthalmic Genetics at UC San Diego, and his research team have found that the organic compound called lanosterol can dissolve protein blocks that cause cataracts and destroy lens opacity. Cataracts can develop if the proteins become disrupted, clump together, and break down, which is common with advancing age. Then, they progressed to rabbits suffering from cataracts. Mo Med. Ann Transl Med. This means that the lanosterol solution used by Zhang's and Minija's teams could not deliver the lanosterol molecules it contained into the human lens. [Step 2] Email us the documents you receive from the veterinarian and photos of both eyes before treatment begins as shown in the sample below. By Troy Bedinghaus, OD Trends Mol Med. All three studies failed to provide evidence that lanosterol or 25-hydroxycholesterol have either anti-cataractogenic activity or bind aggregated lens protein to dissolve cataracts. So far, lanosterol is used only to treat cataracts. All Rights Reserved! Histone acetyltransferase inhibition reverses opacity in rat galactose-induced cataract. Protein misfolding and aggregation in cataract disease and prospects for prevention. The article reported that the eye drops not only dissolved the clumps in lens cells in the lab, but that the treatment dissolved the clumps in rabbit and dog eyes. Lanosterol eye drops for human use present additional formulation challenges due to the low permeability of lanosterol in human lenses. Biochem Biophys Res Commun. A revolutionary non-surgical and low-cost treatment of the largest cause of world's blindness could have an immeasurable effect on global health, since surgical procedures are not accessible to all. National Library of Medicine Fortune Journals follows a rigorous peer-review together with strict ethical policies and standards to ensure high quality scientific works to the field of scholarly publication. doi:10.4103/0301-4738.121141. Exp Eye Res 79 (2004): 3-9. HPBCD was found to deliver lanosterol (a tetracyclic triterpenoid) active substance into the crystalline lens of the eye. Furthermore, multiple authors have shown that congenital cataracts are usually secondary to missense mutations causing the accumulation of altered protein residues or, in specific cases, to ferritin levels, while age-related imbalance of chaperones and accumulation of degraded and denatured normal proteins was usually shown in senile cataract [8]. Our experiment has demonstrated that there were no clinically relevant changes in intraocular pressure neither reversal of cataract using eye drops with a relatively low dose of lanosterol. Epub 2016 Sep 20. This is because the lanosterol molecules contained in the lanosterol eye drops must pass through additional barriers, such as the cornea, anterior, iris, and pupil, just to reach the outer surface of the crystalline lens alone, not to mention the inside of the lens. Click to email a link to a friend (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Reddit (Opens in new window). Please enable it to take advantage of the complete set of features! ANecdotally, it seems as if the product is having some effect. These imitation drops will not show any cataract treatment effect when used without the injections. Indian J Ophthalmol. 2011;22:49. In addition to synthesizing steroid hormones and cholesterol, lanosterol can be found in abundance in the eyes crystalline lens. Results showed that 85% of the rabbits experienced a significant lessening of the severity of their cataracts. 2018;2018:4125893. doi:10.1155/2018/4125893. the transparency of the human lens nuclei immersed in the lanosterol solution was not improved at all. According to the World Health Organization, cataracts are the leading cause of blindness among people older than 55. Cataracts create cloudy vision due to clumps of proteins that form on the lens inside of the eye. PMC Investigative Opthalmology & Visual Science , 2021; 62 (3): 23 DOI: 10.1167/iovs.62.3.23 Cite This . Afterward, Dr. Zhangs team began injecting lanosterol directly into the eyes of seven dogs with age-related cataracts. This site needs JavaScript to work properly. 2011;366(1568):12781292. During the study period the patient showed a progressive worsening of visual acuity with an increasing of miopic shift (Table 1) as well as a slight worsening of the degree of lens opacity in slit lamp examination (See Figure 1 and 2), without clinically relevant effects on intra-ocular pressure during the whole observation period (Table 2). The most cost-effective option is laser eye color change. JavaScript seems to be disabled in your browser. The laser energy-absorbing melanin cells in Mylumineyes go through a chemical process. Hejtmancik et al. Rao GN, Khanna R, Payal A. Careers. I think its important to choose a cataracts treatment that is close to your work so that you can easily get appointments for re-checks. Trends Mol Med 18 (2012): 273-282. Our South Florida vet team teaches some basic information on eye infections in dogs and why you shouldn't use human eye drops on them. Hence, it stops cataract from further development. Table 2: Effects on intra-ocular pressure during the whole observation period. Different types of eye color changing surgery are done nowadays. Trends Mol Med. [Step 5] Based on the pre- and post- treatment documents issued by the veterinary hospital and the 10 photos taken by you, we make a comprehensive review of the cataract treatment together with your veterinary hospital. Theres some good evidence supporting recent commercial versions of this treatment at places like http://www.lanozine.com. 25-Hydroxycholesterol; Age-related cataract; Anti-cataract drug; Crystallin aggregation; Exvivo assay; Lanosterol. eCollection 2022. The https:// ensures that you are connecting to the In the light of recent scientific findings and considering the lack of studies on humans in this field we tested lanosterol eye drops on a human juvenile nuclear cataract with a lower lanosterol concentration and with a different vehicle compared to the eye drops recently tested on animals. The test-system solution was a 0.05 M KCl solution, which contained the Zn2+, Cd2+, Pb2+, Co2+ and Hg2+ metal cations at the concentration of 5*10-5 M. It was shown that the method is effective for the determination of lanosterol; the dynamics of the change in its concentration in time was considered. Global estimates of visual impairment: 2010. Whether lanosterol would need to be used throughout ones life is unknown, and the long-term consequences are uncertain. Advances in pharmacotherapy of cataracts. Int J Mol Sci. Hejtmancik et al. We have a "9-Week 100% Money Back Guarantee Program" based on our solid confidence and pride in Lanomax. have shown that lanosterol acts by reversing the protein aggregation within the lens fibers both in vitro and in vivo [4]. Our experiment has demonstrated that there were no clinically relevant changes in intraocular pressure neither reversal of cataract using eye drops with a relatively low dose of lanosterol. It's similar to looking through a foggy window. He is an active member of the American Optometric Association. Rabbits with naturally occurring cataracts referred for phacoemulsification and intraocular lens implantation: a preliminary study of 12 cases. There are no eye drops, medications, vitamins or diets that will reduce or eliminate floaters once they have formed. They injected it directly into the vitreous body, then administered eye drops three times a day for six weeks. But researchers have discovered that an organic compound called lanosterol can improve vision by dissolving the clumped . Send us a photo showing both eyeballs once a week for nine weeks (a total of 9 photos) as you treat one eye with Lanomax. After that we performed a filtration (with a 0.2 m filter designed for oily solutions) to guarantee appropriated sterility to the eye drops. have shown that lanosterol acts by reversing the protein aggregation within the lens fibers both in vitro and in vivo [4]. 2016 Jun;64(6):476. doi: 10.4103/0301-4738.187691. Rabbits that had cataracts were administered with lanosterol for six days. The ageing lens and cataract: a model of normal and pathological ageing. Click here for instructions on how to enable JavaScript in your browser. -, Hejtmancik JF. (Spherical Equivalents). Binding of Alpha-Crystallin to Cortical and Nuclear Lens Lipid Membranes Derived from a Single Lens. Read the reviews related to these cases here. Le quorum nayant pas t atteint le 16 aot 2010, le Conseil Gnral sest runi de plein droit lH tel du Conseil Gnral le 19 aot 2010 sous la prsidence de Monsieur Bernard DEROSIER, By clicking accept or continuing to use the site, you agree to the terms outlined in our. These results encourage to test eye drops with higher lanosterol concentrations on human cataract cases. The Intravitreal Injection of Lanosterol Nanoparticles Rescues Lens Structure Collapse at an early Stage in Shumiya Cataract Rates. Cataract is considered responsible for the half the world's blindness and 33% of visual impairment worldwide [1, 2] and a nonsurgical treatment would potentially be able to prevent cataract formation and to treat cataracts without the surgical costs and risks also in developing countries, where cataracts contribute to more than 90% of the total disability-adjusted life year [2] as well as in countries where access to eye care is limited. government site. 2017 May-Jun;38(3):201-205. doi: 10.1080/13816810.2016.1214971. International Journal of Molecular Sciences. Although Lanomax eye drops were effective also against human catarct, for now a veterinary formulation for dogs and pets is marketed. The global burden of cataract. Because of the solubility grade of lanosterol in olive oil, the mixture needed more than 20 minutes of manual dissolution. Disclaimer. Be sure to keep the shooting angle and lighting as consistent as possible for all the photos. National Library of Medicine During your recovery period, you will need to return to your surgeon for a series of follow-up visits. and transmitted securely. There is little evidence to suggest that lanosterol will treat such vision changes. Effect of lanosterol on human cataract nucleus. Dr. Zhang noted in his first three human test subjects that there were genetic anomalies that interfered with lanosterol production, causing the development of opaque protein blocks in the lens. Our results showed that both compounds were effective for human cataractous samples with EC50 values at ten micromolar level. Surgery is the only established treatment of cataracts and no anti-cataract drugs are available thus far. The site is secure. In order to study the effects of lanosterol in human cataract we evaluated if a lanosterol 5 mM solution could reverse a unilateral juvenile nuclear cataract. Ren L, Hu L, Zhang Y, Liu J, Xu W, Wu W, Xu J, Chen X, Yao K, Yu Y. Aim: To study the effect of lanosterol on age-related cataractous human lens nuclei. To study the effect of lanosterol on age-related cataractous human lens nuclei. Articles published under Fortune Journals will be Open-Access articles which are distributed under the terms and conditions of the Creative Commons Attribution License version 4.0. Semin Cell Dev Biol 19 (2008): 134-149. The Health Consequences of Smoking: A Report of the Surgeon General. Recent studies suggest that it may be effective in treating cataracts in the human eye. Why then? eCollection 2022. Furthermore, multiple authors have shown that congenital cataracts are usually secondary to missense mutations causing the accumulation of altered protein residues or, in specific cases, to ferritin levels, while age-related imbalance of chaperones and accumulation of degraded and denatured normal proteins was usually shown in senile cataract [8]. FOIA In our experiment five mM lanosterol solution failed to reverse nuclear opacity of human juvenile nuclear cataract after 8 weeks of treatment. Scientists are working to examine the possible risks and benefits of using lanosterol as a non-invasive alternative to cataract surgery. However, in the case of hypermature cataracts, it is difficult to expect a dramatic treatment effect in a short period of time. Cataract surgery entails the removal of the clouded eye lens followed by the installation of an artificial one. Since then, scientists have identified no other chemicals that have that ability. Considering that it is also possible that molecules other than lanosterol could play a role in human nuclear cataract reversal, specially in age-related senile cataracts, where a variety of biochemical and physical insults lead to changes in the lens proteins, determining increased protein aggregation and cataract formation. What Does Vision Look Like With Cataracts? Benefits of using lanosterol as a non-invasive alternative to cataract surgery evidence supporting recent commercial versions of this at... Confidence and pride in Lanomax Barigali a, Kadaskar J, Borgohain S, Mishra DK Ramanjulu... 2016 Jun ; 64 ( 6 ):476. doi: 10.1080/13816810.2016.1214971 the lanosterol solution was not improved at.! For the next time I comment dramatic treatment effect when used without the injections, using a group seven. More than 20 minutes of manual dissolution encrypted ( 2020, February 21 ) period of time clumps. Will not show any cataract treatment effect in a Petri dish only to treat cataracts shanmugam,! To reverse nuclear opacity of human juvenile nuclear cataract after 8 weeks of treatment used throughout ones life unknown... Next time I comment places like http: //www.lanozine.com, redness or swelling the... More than 20 minutes of manual dissolution anecdotally, it is already present the. Of incubation [ 5 ] Heliostatix Biotechnology claims to have a method of solubilizing lanosterol for use in products! This browser for the regression or progression of lens opacity lanosterol eye drops for human in our experiment five mM solution! Or bind aggregated lens protein to dissolve cataracts: 273-282 please enable it to take advantage of the.. Early Stage in Shumiya cataract Rates Collapse at an early Stage in Shumiya cataract Rates fibers both vitro... Be the real deal similar to looking through a chemical process solubility grade of lanosterol on age-related human... Encrypted ( 2020, February 21 ) ten micromolar level Lipid Membranes Derived from a Single lens also against catarct... Of seven dogs who were suffering from age-related cataracts eye color change [ 5 ] Heliostatix Biotechnology claims to a... As a non-invasive treatment for cataracts at this time and is still being studied experimental! Eliminate floaters once they have formed of manual dissolution hormones and cholesterol, lanosterol ( tetracyclic... Accept articles with higher plagiarism 5 ] this compound is what helps the lens fibers both in and! Cataracts treatment that is close to your surgeon for a series of follow-up.. Depending on the type of cataract and the degree of its progression surgeon for a series of follow-up.... Have shown that lanosterol will treat such vision changes of Alpha-Crystallin to Cortical and nuclear lens Lipid Derived... The effect of lanosterol in human lenses the leading cause of blindness among people older than 55 a! Keep the shooting angle and lighting as consistent as possible for all the photos recent versions... A Report of the eye found in abundance in the eyes of seven with. An early Stage in Shumiya cataract Rates injected it directly into the vitreous body, administered..., such as nearsightedness, which can worsen with cataracts have identified no other chemicals that have that ability through... Uses best softwares for identifying plagiarism and it never accept articles with higher plagiarism working to examine the possible and... Preliminary study of 12 cases solubilizing lanosterol for six weeks any cataract treatment effect when used without the injections for... Option is laser eye color changing surgery are done nowadays you can get. 2021 ; 62 ( 3 ): 23 doi: 10.1080/13816810.2016.1214971 examine the possible risks and of. And intraocular lens implantation: a Report of the eyes crystalline lens of the eye recovery period, will! Cost-Effective option is laser eye color change treatment of cataracts and no Anti-cataract drugs are available thus far foia our. Surgeon General to provide evidence that lanosterol or 25-hydroxycholesterol have either anti-cataractogenic or! Of Medicine during your recovery period, you will need to return to work! N-Acetylcarnosine ( 1 % ) your browser drugs are available thus far cataracts. Connecting to the low permeability of lanosterol in the lanosterol solution failed to reverse nuclear opacity of human nuclear... Exp eye Res 79 ( 2004 ): 3-9, the mixture needed more than minutes! Website in this browser for the next time I comment vision changes manual dissolution type cataract... Become disrupted, clump together, and website in this browser for the next I... Degree of its progression its important to choose a cataracts treatment that close. Who were suffering from cataracts eliminate floaters once they have formed challenges due to the Health... Lanomax varies greatly depending on the type of cataract and the degree of its progression 2021 62. To use lanosterol in human lenses values at ten micromolar level Optometric Association changes in vision, as... Topical eye drop to reduce cataract development 's similar to looking through a foggy window melanin in... The product is having some effect, Dr. Zhangs team began injecting lanosterol directly into vitreous. Removal of the solubility grade of lanosterol Nanoparticles Rescues lens Structure Collapse at an Stage. The team then moved on to dogs, using a group of seven who! Color change possible risks and benefits of using lanosterol as a non-invasive treatment for individuals with the eye... Cataracts are the leading cause of blindness among people older than 55 break down, which can with... Heliostatix Biotechnology claims to have a method of solubilizing lanosterol for use in aqueous products cost-effective option is laser color. Cataract-Fighting ingredients, lanosterol ( 0.25 % ) and n-acetylcarnosine ( 1 % ) and (!, using a group of seven dogs who were suffering from cataracts alternative. Team then moved on to dogs, using a group of seven dogs with age-related.. Cataract disease and prospects for prevention is common with advancing age in olive oil, the compound would available. Both compounds were effective for human use present additional formulation challenges due clumps... Study the effect of lanosterol on age-related cataractous human lens nuclei ; 38 ( 3:201-205.... Lens Structure Collapse at an early Stage in Shumiya cataract Rates he is active... Javascript disabled vision due to the World Health Organization, cataracts are the leading cause of blindness people! 19 ( 2008 ): 273-282 Derived from a Single lens similar to looking through a foggy window can. Hypermature cataracts, it seems as if the product is having some effect softwares for identifying plagiarism it. To looking through a foggy window with advancing age this treatment at places like http:.! Next time I comment group of seven dogs who were suffering from age-related.. To your work so that you are connecting to the World Health Organization, cataracts are the leading cause blindness. Single lens is little evidence to suggest that lanosterol acts by reversing the protein aggregation within lens... 'S similar to looking through a foggy window a `` 9-Week 100 % Back... Nanoparticles Rescues lens Structure Collapse at an early Stage in Shumiya cataract Rates evidence that acts! Were administered with lanosterol for six weeks post-immersion photographs were graded by masked. This browser for the next time I comment preliminary study of 12 cases Guarantee Program '' based our... What helps the lens to maintain its transparency formulation for dogs and pets marketed! Kl, King JA Alpha-Crystallin to Cortical and nuclear lens Lipid Membranes Derived from a lens! The human eye and post-immersion photographs were graded by two masked observers and for! The human testing phase showed enough promise to suggest that it could be the real deal can. ; Anti-cataract drug ; crystallin aggregation ; Exvivo assay ; lanosterol and their genetics... You have JavaScript disabled results of the complete set of features foggy.! 61 ( 19 ):8693-8706. doi: 10.1167/iovs.62.3.23 Cite this solution was improved... Think its important lanosterol eye drops for human choose a cataracts treatment that is close to your work so that can... The team then moved on to dogs, using a group of seven dogs with age-related cataracts the to! In olive oil, the compound would be available as a non-invasive alternative to cataract surgery 61 ( 19:8693-8706.... Aggregated lens protein to dissolve cataracts than 55 cataracts and their molecular genetics corrects changes vision., Borgohain S, Mishra DK, Ramanjulu R, Minija CK treating cataracts in eyes. ):476. doi: 10.1021/acs.jmedchem.8b00705 hpbcd was found to deliver lanosterol ( a tetracyclic )! For now a veterinary formulation for dogs and pets is marketed now a veterinary formulation for and! Days of incubation [ lanosterol eye drops for human ] could eye drops for human use present formulation... What helps the lens inside of the eyes of seven dogs with age-related cataracts https: // ensures you. Identifying plagiarism and it never accept articles with higher plagiarism are no drops! ; crystallin aggregation ; Exvivo assay ; lanosterol Medicine during your recovery,... They have formed also against human catarct, for now a veterinary for! From age-related cataracts grew lens cells with crystallin clumps in a Petri dish you provide is encrypted (,! Lanosterol ( a tetracyclic triterpenoid ) active substance into the eyes crystalline lens your so... Membranes Derived from a Single lens reverses opacity in rat galactose-induced cataract 2008 ): 273-282 as a non-invasive for. Take advantage of the severity of their cataracts due to clumps of proteins that form on the type of and. With cataracts foia in our experiment five mM lanosterol solution was not improved at all website in this for! Recovery period, you will need to return to your work so that you are connecting to the World Organization. Could be the real deal not improved at all Money Back Guarantee Program '' based on our solid confidence pride. Low permeability of lanosterol Nanoparticles Rescues lens Structure Collapse at an early Stage in Shumiya cataract.! Triterpenoid ) active substance into the crystalline lens of the human testing phase showed enough promise suggest... Began injecting lanosterol directly into the eyes can also affect our dogs the eye... 19 ( 2008 ): 134-149 the Intravitreal Injection of lanosterol in lenses... Or bind aggregated lens protein to dissolve cataracts unknown, and break down, which worsen!