Anterior subcapsular cataracts are classically linked to which drug class?

• A. Phenothiazines (chloro-, thio-)
• B. Amiodarone
• C. Timolol
• D. Doxycycline

Answer: (A)

Anterior subcapsular cataracts are a classic adverse effect of phenothiazine antipsychotics such as chlorpromazine and thioridazine. The drug tends to accumulate in ocular tissues and damages the anterior lens epithelium, producing opacities just beneath the anterior capsule. These lesions are typically located in the subcapsular area and can be dose- and duration-dependent, sometimes appearing with corneal deposits as well. In contrast, amiodarone more commonly causes corneal verticillata (whorl-like corneal deposits) and less predictably lens changes; timolol and doxycycline do not characteristically produce anterior subcapsular cataracts. Thus, phenothiazines best explain the finding.