A 48yo woman who has been taking medications for asthma for a long time has now presented
with decreasing vision. What is the most probable cause for her decrease in vision?
a. Inhaled salbutamol
b. Inhaled steroids
c. Aminophylline
d. Beta-blockers
e. Oral steroids
answer: E
Patients maintained on systemic corticosteroids for many years in treatment of asthma, rheumatoid arthritis, prophylaxis of a renal graft rejection etc, may develop cataract. A dose of 15 mg prednisolone a day is regarded as safe in an adult for two or three years.
The cataract is typically posterior subcapsular and starts in the axial part of the lens. Its affect on vision is therefore early. Stopping steroids may stop progression but this is rarely possible because of the nature of the treated systemic disorder.