Are my eyes fuzzy? Cataracts and asthma
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The sun is shining, the birds are singing and my lungs are iffy. What is going on, on this beautiful day? The tip off would be my glasses fogging up, even the lenses in the ophthalmologist office on the special equipment was fogging up. Thank goodness, it was humidity and not my eyes getting worse. phew!

Ironically, asthma is what precipitated this rush to get to the eye doctor. I had been noticing that I had not been seeing as well, I was needing to adjust my eyes to read reports. I had wondered if this was a product of too much screen time. I swear that adults are the worst!  It was time for a cataracts checkup.  Did you know that corticosteroid used in asthma treatment a risk factor for cataracts?  The use of systemic corticosteroids is an established risk factor for the development of posterior sub capsular cataracts. 1. There are some theories that the relationship or risk factors of developing cataracts is linked to the corticosteroid dosage. However more data is needed to correlate this relationship. 2 ICS has been associated with a higher prevalence of posterior sub capsular cataracts. (PSC) 3 “This type of cataract begins as a small opaque or cloudy area on the “posterior,” or back surface of the lens. It is called “sub capsular” because it forms beneath the lens capsule, which is a small “sac,” or membrane, that encloses the lens and holds it in place. “4 and nuclear cataracts,” is the most common type of age-related cataract, caused primarily by the hardening and yellowing of the lens over time. “Nuclear” refers to the gradual clouding of the central portion of the lens, called the nucleus; “sclerotic” refers to the hardening, or sclerosis, of the lens nucleus.” 4

Experiences may vary

It is important to note that not every asthmatic is at risk and that individual experiences vary. Patients should not alter their medications without first speaking to their care team. In my experience, ophthalmologist is really good about further investigating if you have risk factors for cataracts or eye disease related to treatment for other disease like asthma. They also keep tabs on my dosing and any correlations. Both my respirologist and ophthalmologist have confirmed that my early cataracts is most likely related to corticosteroid use for my asthma. The reality is that without the corticosteroids I would have much larger issues, like breathing. That being said I recently had a discussion with my doctor between breathing and seeing. You only get one set of eyes and I may have been able to make different decisions regarding asthma medication choice. This is a much larger discussion and it is best to speak with your doctor about your specific situation.

view references
  1. Tirupati Nath, Subham Sinha Roy, Himanshu Kumar, Rachit Agrawal, Santosh Kumar, S. K. Satsangi. . (2017) Prevalence of Steroid-Induced Cataract and Glaucoma in Chronic Obstructive Pulmonary Disease Patients Attending a Tertiary Care Center in India. Asia-Pacific Journal of Ophthalmology 6:1, 28-32.
  2. www.med.umich.edu/lrc/.../course.../asthma.../inhaled_corticosteroids_cataracts.ppt
  3. Use of Inhaled Corticosteroids and the Risk of Cataracts. Robert G. Cumming, M.B., B.S., Ph.D., Paul Mitchell, M.D., and Stephen R. Leeder, M.B., B.S., Ph.D. N Engl J Med 1997; 337:8-14 July 3, 1997
  4. http://www.visionaware.org/info/your-eye-condition/cataracts/different-types-of-cataracts/125
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