Introduction: Organophosphorus poisoning (OPP) is an important health problem in many parts of the world particularly in developing countries. However, the treatment did not change since many years, despite the increasing complications and case fatalities of the exposure. From the clinical experience, some pharmacologic agents had proved useful in improving the outcome and decreasing the complications of this exposure.

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The present study comprised 60 cataractous male patients aged from 44-55 years who attended Ophthalmic Center of Mansoura University. They were categorized into two groups; the first group comprised 15 patients who had never smoked before with minimal exposure to cigarette smoking (served as a control group) while the second group comprised 45 age,body mass index matched smokers. Smokers were classified according to Ferris Smoking Index (packs / day x 365 x number of years of smoking) into light (smoke 1000 packs), moderate (smoke 1000-6000 packs) and heavy (smoke > 6000 packs) smokers. Blood cadmium and lead concentrations were measured and their levels in the cataractous lens nuclei were also estimated. The levels of some antioxidants such as serum vitamin C; E and beta carotene were determined. Cadmium had a statistically significant higher concentration in blood and lenses of smokers compared with that of non smokers (p<0.0001). There was a threefold increase in blood cadmium concentration (9.54 + 0.25 µg/dl) in heavy smokers and twofold increase in moderate and low smokers (6.87 + 0.77 and 6.38 + 0.36 µg/dl respectively) while it was 3.37± 0.4 µg/dl in non smokers. There was a significantly high accumulation of cadmium in lenses of cataractous smokers reaching about fourfold increase in heavy smokers (1.73 + 0.05 µg/gm) nearly threefold increase in moderate and low smokers (1.36 + 0.08 and 1.13 + 0.05 µg/gm respectively) when compared to that of non smokers (0.42 + 0.11 µg/ gm). A highly significant elevation of blood lead concentrations and lenses lead was observed in smokers when compared to non smokers. As regard vitamin E, C and beta carotene, a highly significant reduction was observed in smokers when compared with non smokers). There was a highly positive correlation between blood cadmium concentrations and both lens cadmium levels, blood lead concentrations & lens lead levels in moderate and heavy smokers. A highly negative correlation between blood cadmium concentration and serum Vitamin E and C levels of smokers was also observed. In conclusion, cadmium present in high concentrations among smokers was found to have an important role in cataractogenesis, through induction of oxidative stress as evidenced by reduction of levels of some antioxidant studied in