It is known that androgen deprivation therapy (ADT) is associated with weight gain, dyslipidaemia and insulin resistance and that cataracts are also associated with these metabolic disorders. In this report the authors examined the effect of ADT on the risk of developing cataracts. Using a Medicare database the authors estimated the risk of cataract development among 65,852 patients that received either ADT or orchiectomy for prostate cancer and calculated that gonadotropin-releasing hormone agonist use was associated with a modest increase in cataract incidence (HR 1.09, 95%CI: 1.06 to 1.12) and orchiectomy with a larger increase in risk (HR 1.26, 95% CI: 1.07 to 1.47). The authors feel that further studies are required to support or refute these findings.