Steroid induced cataract treatment

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.

Ann Allergy Asthma Immunol . 2006 Apr;96(4):514-25.
Concerns about intranasal corticosteroids for over-the-counter use: position statement of the Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology.
Bielory L, Blaiss M, Fineman SM, Ledford DK, Lieberman P, Simons FE, Skoner DP, Storms WW; Joint Task Force of the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology.
Source
Department of Medicine, UMDNJ-New Jersey Medical School, Newark, USA.
Abstract
The Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology was charged with formulating a position paper regarding the potential release of intranasal corticosteroids for over-the-counter use. We took the position that safety issues regarding this proposal would be our sole concern. We reviewed the literature to evaluate the frequency and severity of potential adverse events related to the administration of intranasal corticosteroids. We limited this review to 5 areas: (1) effects on growth, (2) ocular effects, (3) effects on bone, (4) effects on the hypothalamic-pituitary-adrenal axis, and (5) local adverse effects. After review of the available data, we concluded that intranasal corticosteroids should remain prescription-only drugs. Patients receiving an intranasal corticosteroid should be instructed in its use and that use should be monitored by a physician or an appropriately trained medical provider (eg, nurse practitioner or physician assistant) under the direct supervision of a physician. This conclusion was reached based on the evidence that corticosteroids administered by any route, including the intranasal route, have the potential to cause adverse effects in all the areas noted herein. Our conclusion was strengthened by the fact that these adverse effects can be insidious and therefore not evident for many years; there is the potential for overuse; patients could also have access to other forms of topically administered corticosteroids, thus increasing their total dose; and individuals vary in their susceptibility to corticosteroid-induced adverse effects. We were also influenced to take this position knowing that generally reassuring data regarding the use of respiratory tract-administered corticosteroids are based on mean data and that all such studies have shown outliers in whom adverse effects were evident. Thus, as stated, we recommend that intranasal corticosteroids remain prescription-only drugs.

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.

Cataract surgery has evolved to now be a refractive procedure, giving our patients more options than ever before. The current treatment options are safe, accurate and can treat all types of refractive errors. Staying abreast of the latest advancements is essential to being a part of the co-management process.  

Dr. Johnston practices at Georgia Eye Partners in Atlanta, GA, where he serves as the clinical director and residency director. He focuses on ocular surface disease and has experience in comanaging cataract and refractive surgery patients.  

Steroid induced cataract treatment

steroid induced cataract treatment

Cataract surgery has evolved to now be a refractive procedure, giving our patients more options than ever before. The current treatment options are safe, accurate and can treat all types of refractive errors. Staying abreast of the latest advancements is essential to being a part of the co-management process.  

Dr. Johnston practices at Georgia Eye Partners in Atlanta, GA, where he serves as the clinical director and residency director. He focuses on ocular surface disease and has experience in comanaging cataract and refractive surgery patients.  

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