Cataract surgery is now so streamlined and commonplace, it can almost seem like an inevitable part of aging. However, the procedure isn’t risk free—and some people can’t have the surgery. Wouldn’t it be wonderful if cataracts could be treated with something as simple as an eyedrop? That may be more than wishful thinking!

About 20% of people over age 60 and 80% over age 75 have cataracts. It’s the leading cause of blindness worldwide, largely because cataract surgery, the only approved treatment, requires highly trained surgeons and high-tech surgical equipment that are not available in many parts of the world. In the US, however, cataract surgery is a simple, painless, outpatient procedure that is usually covered by insurance. (Note: Certain kinds of corrective implantable lenses may not be covered.) However, the procedure can have complications, especially for patients with other eye conditions, such as macular degeneration or glaucoma. Even without other eye conditions, while most of the time one procedure is sufficient, it’s not uncommon to need additional surgeries to adjust vision.

Cataracts 101

Cataracts form when oxidative stress—such as from sun exposure, diabetes, high blood pressure, smoking or simply aging—damages protein molecules in the lens of the eye, causing them to clump together. Normally, the protein molecules are arranged in a way that lets light pass through. When the molecules clump, they cloud areas of the lens…and as the clumps grow, larger areas of the lens cloud, making it harder and harder to see.

Antioxidants can reduce or prevent cell damage caused by oxidative stress. One antioxidant in particular, N-acetylcarnosine (NAC), is a strong antioxidant that occurs naturally in the heart, muscles and brain. Human studies have demonstrated that NAC eyedrops can improve cataracts.

What the Research Shows

Most of the research on NAC eyedrops for cataracts has been done in Russia, and the most impressive study comes from Hemholtz Research Institute of Eye Disorders in Moscow and was published in Journal of Anti-Aging Medicine. For the study, 49 patients (average age 65) with cataracts received either NAC eyedrops or placebo eyedrops twice daily. After 24 months, 90% of the NAC group had significant improvement in their cataracts…compared with significant progression of their cataracts in nearly 90% of the placebo group. The researchers found that adding an acetyl molecule to NAC allowed it to be absorbed through the front (anterior chamber) of the eye, where it could counteract oxidative stress in the eye lens.

The FDA will need more research, such as large studies, before approving NAC eyedrops for treating cataracts. However, eyedrops approved as moisturizing drops that contain 1% NAC, the same strength used in the study, are available now without prescription. People with cataracts—and some eye doctors—have been treating cataracts with the drops and reporting good results. Brands include Can-C, which contains the same formula that was used in the Russian trials, and OcluMed, which contains additional nutrients that are beneficial for treating cataracts.

Should You Try NAC Eyedrops?

It’s important to note that NAC drops are most effective for nuclear cataracts—age-related cataracts that form in the center of the lens—that are still at an early stage. The drops will not improve cataracts present at birth…subcapsular cataracts (cataracts that form at the back of the lens, often from diabetes or taking high doses of steroid medications)…or cortical cataracts (cataracts that form at the edges of the lens). While NAC drops may slightly improve advanced cataracts, they are unlikely to improve vision enough to avoid the need for surgery.

The usual treatment is one drop twice a day and can be continued as long as there is vision improvement. The only side effect experienced by some people is a few seconds of slight stinging when applying the drops, especially if eyes are dry. People who wear contact lenses should wait 15 minutes after applying the drops before putting on contacts.

Check with your eye doctor before using this or any other kind of eyedrops. As there are no known risks, medical condition warnings or other contraindications, NAC drops may be worth trying, particularly if your cataracts are at an early stage. If the drops are going to help, you should see an improvement within the first three months. Even if your cataracts aren’t completely reversed, NAC drops may at least keep them from progressing…or slow their progression so that you can hold off longer on surgery. Taking oral supplements of glutathione, n-acetyl cysteine, alpha-lipoic acid and vitamin C also can help slow down the progression of cataracts.

Besides NAC eyedrops, remember that healthy vison also depends on a healthy lifestyle…

  • Don’t smoke.       
  • Wear sunglasses.
  • Eat plenty of fruits and vegetables to get more antioxidants.
  • Work with your doctor to control diabetes and/or high blood pressure.
  • Limit alcohol.