To the Editor.
—Reports of tobaccosis cataract among physicians and nurses1,2 strengthen our knowledge of the role of cigarette smoking in the causation of cataract, while also indicating a need for improved understanding of the pathogenesis and prevention of cataract.A common thread in the many conditions involved in the epidemiology of cataract—aging, smoking, ultraviolet light exposure, hypertension, atherosclerosis, coronary thrombosis, diabetes, and the like—is mutagenesis by ionizing radiation, chemicals, and viruses, causing deviation of cellular characteristics from the normal,3 accelerated aging, and a broad spectrum of degenerative diseases including cataract.When seeking causes of the occurrence of precocious cataract in individuals and populations, one should remember that the principal determinants are inherent genetic structures modified by lifetime exposure to radiant, inhaled, and ingested mutagens—and that effects of cell ablation and mutation in early life are magnified by growth and development of the organism, as stated in a
Ravenholt R. Cigarette Smoking and Risk of Cataracts. JAMA. 1993;269(6):747-748. doi:10.1001/jama.1993.03500060047026