Lipids as pharmacological targets in age-related lens disease

Cataract and presbyopia are the leading causes of age-related vision impairment worldwide, yet non-surgical management options remain limited. Age-related changes in the lipid composition of the crystalline lens have been implicated in their pathophysiology, highlighting the lens lipidome as a potential therapeutic target. In this review we summarize how recent advances in high-resolution and spatial lipidomics have clarified age- and region-specific changes in the lens lipidome, and we evaluate recent research efforts to utilize topical lipid-replenishing formulations and lipid-modifying small molecules to reverse these changes. We outline challenges in drug delivery to the avascular and encapsulated lens, and highlight how emerging technologies such as nanoparticles may overcome barriers to lens penetration, providing a path toward a pharmacological lens intervention.