Objective: To observe the effectiveness and safety of black rice anthocyanins in preventing cataracts and age-related macular degeneration (dry form). Methods: Patients with cataracts and age-related macular degeneration who were outpatients or inpatients at the Ophthalmology Department of Changchun Hospital of Traditional Chinese Medicine from December 2024 to December 2025 were selected as the study subjects. They were randomly divided into an observation group and a control group, with 50 cases in each group, using a random number table method. The observation group received oral black rice anthocyanins, while the control group received oral vitamin C pills. Both groups were treated for 20 days and observed for 3 months. Visual acuity, lens, and retina conditions were compared before and after treatment to verify whether black rice anthocyanins could effectively prevent the occurrence and development of cataracts and age-related macular degeneration (dry form) and delay disease progression. Results: Comparing the clinical efficacy of the two groups, the observation group had a total effective rate of 84%, while the control group had a total effective rate of 62%. The observation group was significantly superior to the control group. After χ² testing, p = 0.013, p < 0.05, indicating a significant difference in the total effective rates between the two groups. In terms of visual acuity and the number of lines improved, the observation group was significantly superior to the control group. Conclusion: Black rice anthocyanins effectively improve visual acuity, lens opacity, and retinal conditions in patients with early-stage cataracts and age-related macular degeneration (dry form), demonstrating definite clinical efficacy and safety without side effects. This study provides a new approach for the early prevention of cataracts and age-related macular degeneration (dry form).