Steroid induced cataracts

The diagnosis of cataract is usually made when the patient begins to notice changes in his or her vision and consults an eye specialist. In contrast to certain types of glaucoma, there is no pain associated with the development of cataracts. The specific changes in the patient's vision depend on the type and location of the cataract. Nuclear cataracts typically produce symptoms known as myopic shift (in nearsighted patients) and second sight (in farsighted patients). What these terms mean is that the nearsighted person becomes more nearsighted while the farsighted person's near vision improves to the point that there is less need for reading glasses. Cortical and posterior subcapsular cataracts typically reduce visual acuity; in addition, the patient may also complain of increased glare in bright daylight or glare from the headlights of oncoming cars at night.

Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'. Growth of natural lens cells remaining after the natural lens was removed may be the cause, and the younger the patient, the greater the chance of this occurring. Management involves cutting a small, circular area in the posterior capsule with targeted beams of energy from a laser, called Nd:YAG laser capsulotomy, after the type of laser used. The laser can be aimed very accurately, and the small part of the capsule which is cut falls harmlessly to the bottom of the inside of the eye. This procedure leaves sufficient capsule to hold the lens in place, but removes enough to allow light to pass directly through to the retina. Serious side effects are rare. [56] Posterior capsular opacification is common and occurs following up to one in four operations, but these rates are decreasing following the introduction of modern intraocular lenses together with a better understanding of the causes.

Dr. Olson added that oftentimes primary care physicians prescribe steroid medications for patients with allergies or asthma without completely understanding the repercussions these medications can have. He cited his own case as an example. “I have taken inhaled steroids long-term for asthma and nasal decongestion. I worry that I could develop a cataract and/or glaucoma someday as a result of this. I did not understand the risk because the prevailing wisdom was that there was no systemic impact from the dose I was on. Now the risk is clearly not zero but is still poorly understood.”

I had Lasik surgery the summer of 2009 at age 45. I was considered a good candidate for the surgery. I had very good vision (20/15) for almost 2 years, but then started noticing changes. My regular eye doctor thought that I was simply suffering from dry eye. After about 8 months of treatment, the doctor could see cataracts forming. I just had cataract surgery on my left eye Feb 26, 2014 at age 50, only 2-1/2 years after noticing the first vision degradation. The cataract was rated 3+. This cataract caused blurring and multiple images, rather than cloudiness or discoloration. I also have a cataract forming in my right eye, though it isn't progressing as aggressively as the left eye did. I do not have any health issues such as diabetes, I never took steroids except for the eye drops after Lasik surgery, and I have never had any type of eye injury which would cause early cataracts. I believe that the Lasik surgery or follow-up eye drops caused me to develop early, aggressive cataracts.

Compared with the general population, patients with diabetes tend to develop cataracts at an earlier age. 42,43 They also have a propensity to progress more quickly. Visual symptoms commonly occur as a result of secondary myopia, with hyperosmotic lens changes secondary to hyperglycemia. 42,43 Often, cataracts noted in young diabetes patients present as diffuse posterior and anterior subcapsular or cortical snowflake opacities. 42,43 Although the pathogenesis of the diabetic cataract is not completely understood, many theories exist. 42-44  

Steroid induced cataracts

steroid induced cataracts

I had Lasik surgery the summer of 2009 at age 45. I was considered a good candidate for the surgery. I had very good vision (20/15) for almost 2 years, but then started noticing changes. My regular eye doctor thought that I was simply suffering from dry eye. After about 8 months of treatment, the doctor could see cataracts forming. I just had cataract surgery on my left eye Feb 26, 2014 at age 50, only 2-1/2 years after noticing the first vision degradation. The cataract was rated 3+. This cataract caused blurring and multiple images, rather than cloudiness or discoloration. I also have a cataract forming in my right eye, though it isn't progressing as aggressively as the left eye did. I do not have any health issues such as diabetes, I never took steroids except for the eye drops after Lasik surgery, and I have never had any type of eye injury which would cause early cataracts. I believe that the Lasik surgery or follow-up eye drops caused me to develop early, aggressive cataracts.

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