The purpose of the present study was to identify metabolic biomarkers and study the metabolic changes in relation to cataracts and eyeball rupture in human aqueous humor. This case-control study included 3 patients with traumatic ocular rupture treated by surgery as the control group, 10 patients with severe cataracts as the severe cataracts group and 10 patients with mild cataracts as the mild cataracts group. The present study used liquid chromatography-mass spectrometry to analyze the metabolomics of aqueous humor samples. Databases including the Kyoto Encyclopedia of Genes and Genomes and MetaboAnalyst were used to find potential pathways for metabolites. Aqueous humor metabolic spectrum can competently distinguish patients with different degrees of cataracts from the control group. A total of 34 metabolites were identified as potential biomarkers that could distinguish patients with different degrees of cataracts; 36 metabolites were identified as potential biomarkers that could distinguish patients with severe cataracts from the control group; 34 metabolites were identified as potential biomarkers that could distinguish patients with mild cataracts from controls. In pathway analysis, glycerolphospholipid metabolism was highly affected, which meant that these metabolic markers serve an important role in the regulation of this pathway. The present study identified valuable metabolic biomarkers and pathways, which is helpful for an improved understanding of the pathogenesis of cataracts. This discovery has transformation value for the development of new treatment methods for cataracts.Copyright: © Wei et al.