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Dr. Andrew Rynne

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Is castor oil safe to use for cataract?

Answered by
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Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

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Posted on Sat, 23 Aug 2014 in Vision and Eye Disorders
Question: Castor oil is an anecdotal remedy for cataracts, which I want to try out. But I had a retinal detachment repair by scleral buckle and cryotherapy 15 years ago. Cryotherapy creates scar tissue which holds the retina down to the choroid. Castor oil has a reputation for reducing, softening and weakening scars. I need to explore topical castor oil for cataracts, but I don't want to risk a retinal redetachment.
WIthout telling me to have surgery for the cataracts, do you think castor oil could compromise the retinal repair?
doctor
Answered by Dr. Dadapeer K 50 minutes later
Brief Answer:
Castor oil is not known to affect retina.

Detailed Answer:
Hello
Welcome to Health care magic

I am Dr. Dadapeer K, an Ophthalmologist and I answer health problems related to eye.

It seems from the history that you want to try castor oil drops as a remedy for cataract.
Castor oil is a vegetable oil with lot of medicinal properties. It is commonly used as a laxative agent in treatment of constipation. It is also used as skin cream and in many artificial tears eye drops as a base.

Generally it is not known to cause any side effect relating to the retina or other parts of the eye other the allergic reaction to the oil.

But castor oil and its use in preventing cataract or in reversing the cataract is not proven. Generally many of the antioxidants are known to decrease the progression of cataract but as of now none of the medications or solutions are available which can dissolve the cataract and cure it without the need for cataract surgery.

Green leafy vegetables, fruits rich in vitamin C like oranges, vitamin A rich foods like carrots are also known to decrease the progression of cataract.

Hence I can tell you that though there is no evidence of castor oil curing cataract, but as per literature it is not known to cause any effect on the retina or retinal detachment surgery.

But be careful before using or trying this treatment as castor oil needs to be applied directly to the eyes and how safe it is, is not known. If you want home remedies with similar effect you can try the other oral foods and vegetables which provide same effect.
Many antioxidant eye drops are also available commercially like N acetyl carnosine which can decrease the progression of cataract and these can be used more safely as compared to castor oil.

Hope I have answered your question and the information is helpful to you.


Thank you
with regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Dadapeer K 8 hours later
Dear Dr. Dadapeer,
Did you get my follow-up?
Sincerely,
doctor
Answered by Dr. Dadapeer K 5 minutes later
Brief Answer:
Please send your follow up question.

Detailed Answer:
Hello Sir
Please send your follow up question, I have not received your follow up question.

Thank you
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dadapeer K 44 minutes later
Dear Dr. Dadapeer,
Thankyou for your reply. It is reassuring that there are no negative reports in the literature regarding the use of castor oil following retinal detachment surgery, but that may just be because no-one who needs to keep the scar holding the retina to the choroid (like me), has ever tried castor oil for cataract. If they had, there might have been a higher occurrence rate of retinal re-detachment, which we do not want to risk. Still, I believe it has substantial advantages for cataract, and perhaps I could use it for a month or so, perhaps long enough to improve the cataract, but not long enough to weaken the retinal attachment scar.
Although there is no scientific data, I know of anecdotal evidence that around 30 people were cured of cataract by castor oil. There may be three reasons why castor oil could be beneficial in cataract:
1) It softens all the eye structures, and can probably permeate the cornea, lens capsule and lens.
2) Castor oil breaks down into undecylenic acid (UDA) and sebacic acid. UDA is one of the most powerful inhibitors known of the enzyme “calpain”, which is mainly responsible for progression of the cataract. In addition, it mops up reactive oxygen species (ROS) and decreases the levels of pro-apoptotic proteins, thus it would tend to support metabolism of lens epithelial cells which produce a small amount of the “chaperone” protein, alpha-crystallin. Alpha-crystallin, in its native, reduced form, “chaperones” other proteins by actively reversing oxidative damage that has been done to them.
3) Castor oil may contain other substances which proteolyse oxidized peptides in the lens.
For these reasons, I believe a randomized, double-blind controlled study of castor oil should begin immediately.
Whereas castor oil is probably an inhibitor of “calpain”, NAC, on the other hand, acts as a “mini-chaperone” in lieu of depleted reserves of alpha-crystallin, although not so well as alpha-crystallin, and in a different way to alpha-crystallin.
Now there is much anecdotal evidence that NAC too has reversed cataract, which also warrants a randomized, double-blind controlled trial. But although NAC may be safer than castor oil, when used alone, it may have very little penetration into the lens. Castor oil may be able to carry NAC right into the nucleus of the lens, making the NAC much more effective.
May I suggest therefore that a randomized, double-blind trial of topical castor oil and NAC eyedrops, administered separately on alternate days, begin immediately, starting today. It would be an act of great mercy to do such a trial in XXXXXXX and Pakistan, where so many people are afflicted by cataract.
Looking forward to your comments, and with kind regards.
     
doctor
Answered by Dr. Dadapeer K 1 hour later
Brief Answer:
Yes we need clinical trials regarding this.

Detailed Answer:
Hello
Thank you for the follow up question.

First I would like to acknowledge the research work you have done on the use of castor oil.

Yes it is true that the castor oil is of good medicinal value and it is being used as drug base and for treatment in various conditions.
The medicinal value of castor oil is because of the presence of polyunsaturated fatty acids and antioxidant property.

Regarding the effect of castor oil on the retinal detachment surgery, no reports are available probably because no one has tried. But probably castor oil cannot penetrate deep enough to affect the scar on the retina.

There are many studies which have proved the efficacy of the N acetyl carnosine in reversing the cataract, but conclusive evidence is not present hence it is not prescribed as a treatment for cataract.

Studies are being done to test the efficacy of the castor oil in treatment of dry eye for its property of osmoprotection are being done and the initial reports are very encouraging.

As far as studies comparing castor oil and NAC drops are not being done as of now and once the reports of the studies testing the osmoprotection role of the castor oil are out it can give lot insights into the medicinal use of castor oil in ophthalmology.

Hope the information is helpful to you.

Thank you
With regards
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dadapeer K 1 hour later
Dear Dr. Dadapeer,
Thankyou so much again.

I was applying topical NAC at 2 drops each morning/evening, but I have reverted now to applying 1 drop in each eye 4 times/day, since the results are said to be better. I stopped doing it more frequently before because the eye doctor said the lens had yellowed, and I thought I had been overdoing it.

Actually, when NAC offers itself as a sacrificial target to spare the lens proteins in oxidation reactions, it produces the same waste product, yellow-colored lipofuscin, as we would get without the NAC. I think the lipofuscin may clog the lens as it does in the retina, and can only be removed by supplementary N-acetyl carnitine or alpha-lipoic acid. So I reduced the frequency of application.
Of course, NAC has other positive effects, like cutting up large aggregates of oxidized proteins into smaller ones which produce less scattering of light and hence less glare. But my own results with NAC after 1 month have been rather disappointing. I still have terrible glare from car headlamps at night, halos around street lamps, and double vision of luminous objects like the moon, and I want to see whether castor oil could improve these symptoms if used in alternation with NAC.
Just two more things about the effect of castor oil on the retinal attachment.

First, do you do retinal surgery yourself?
And when you said the castor oil probably would not penetrate deeply enough to affect the scar, did you mean "deeply enough into the eye", or "deeply enough through the retinal layers"?
I hope castor oil will penetrate deeply enough to reach the back of the lens, where the posterior subcapsular cataract is located, and which is giving me most of the glare. The scar I don't want to lose is located on the peripheral retina, just behind the lens. It is hard to believe that something which can get to the back of the lens and penetrate it, will not also penetrate through the retinal layers.
Many thanks once again.

Well, this information has been most helpful. Thankyou again for your caring and sympathetic support.
Kindly,


doctor
Answered by Dr. Dadapeer K 2 hours later
Brief Answer:
NAC may only delay progression of cataract.

Detailed Answer:
Hello
Thank you for the follow up question.

Regarding the use of N acetyl cysteine for treatment of cataract, the results as you yourself have experienced are not very promising. But it is supposed to be effective in delaying the progression of cataract rather than reversing the cataract changes.

I am Medical retina specialist I won't operate on retina but I practice medical retina which involves giving intravitreal injections, lasers...
Usually the topically applied drugs cannot cross the vitreous that's why we need to use intravitreal injections in case of diseases of the vitreous and retina. So whether castor oil can penetrate and reach the retinal layers is not known because this study has not been done before.
But most of the topically applied eye drops will not reach the posterior segment in sufficient quantity to produce desired therapeutic effect and because of this we go for intravitreal injections.

Hope I have answered your questions and the information is helpful to you.


Thank you
with regards


Above answer was peer-reviewed by : Dr. Prasad
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