Cataracts From Inhaled Steroids?

We have known for some time that the use of systemic corticosteroids is a risk factor for the development of posterior subcapsular cataracts. A zero risk, or at least, lesser risk has been assumed for inhaled corticosteroids—until this study was published.

The authors conducted a population based study of almost 4,000 adults in Sydney, Australia, correlating the incidence of various types of eye disease with both systemic and inhaled corticosteroids.

The results revealed that higher cumulative lifetime doses of inhaled beclomethasone (for pulmonary problems, usually asthma or emphysema) were associated with higher risks of posterior subcapsular cataracts and nuclear cataracts.

(Cummings R, et al. Use of inhaled corticosteroids and the risk of cataracts. N Eng J Med 1997; 337:8-14).

COMMENT: Considering that one-third of children with asthma continue to have symptoms as adults, and the extensive use of inhaled corticosteroids, we can anticipate an increasing number of cataracts in young adults. Routine slit-lamp exams by ophthalmologists may become the rule for those on long-term therapy. - R.A.