This paper highlights current pharmacotherapeutic modalities for various metabolic disorders which result in cataract. This therapy is preferable for the prevention and treatment of lens opacities due to less financial costs and ease of use. A novel strategy of the medical treatment for cataract was developed. Several compounds prevent the generation of lens protein aggregates and to contribute to their degradation. Oxidative stress, excessive quinoid substances, and activation of aldose reductase promote cataract progression. Quinoid theory suggests that quinones, which are produced because of impaired metabolism of aromatic amino acids (tryptophan, tyrosine etc.) are important for cataractogenesis. Lens opacity occurs when its water-soluble proteins denature and transform into dense compounds under the influence of quinones. Many studies clearly demonstrate that Catalin (pirenoxine) eye drops provide anti-cataract effect on all layers of the lens, in particular, cortex and posterior capsule. High therapeutic efficacy and long-term safety allow for recommending Catalin to slow the progression of cataract, in particular, early cataracts in patients under 59 years of age. Further studies are needed to assess the effects of pirenoxine in various cataracts and risk of cataracts. Cited published data best illustrate the crux of this issue. Keywords: lens, cataract, antioxidants, quinoid compounds, cataractogenesis, medical treatment, pirenoxine, oxidative stress. For citation: Kovalevskaya M.A., Vladimirova Yu.V., Filina L.A., Kokorev V.L. Current conceptions and promising tools to prevent cataractogenesis. Russian Journal of Clinical Ophthalmology. 2021;21(1):24–28. DOI: 10.32364/2311-7729-2021-21-1-24-28.