To the Editor.
—I read with great interest the two prospective studies demonstrating the relationship between smoking and cataracts.1,2 I have been studying this relationship since 1984. I coined the term "Roy's syndrome" in 1985 to describe the use of tobacco products causing posterior subcapsular and cortical cataracts, with an earlier onset in one eye.3The lens is the only epithelial structure to retain its earliest cells throughout life. Chronic insults can thus cause structural changes (cataracts). For example, a popular ocular differential diagnosis book lists 17 causes of nuclear cataract, 22 causes of cortical cataract, and 72 causes of posterior subcapsular cataract.4 In upcoming years, I expect additional causes to be demonstrated for cataracts.These two excellent prospective studies suggest an earlier onset of cataract in one eye than in the other eye. In our patient study we tried to identify the cause of onset and