POSTERIOR SUBCAPSULAR CATARACT AND INHALED CORTICOSTEROID-THERAPY

Background - Although posterior subcapsular cataract complicates both systemic and topical corticosteroid therapy, the literature on the eff ects of inhaled corticosteroids is conflicting. Methods - One hundred and forty children and young adults on inhaled corticosteroids were ex amined by slit lamp ophthalmoscopy after pupillary dilatation; 103 had received one or more short courses (less than or equal to 7 days) of oral corticosteroids in the management of acute asthmatic attacks and four had also received one or more prolonged courses (greater than or equal to 4 weeks) of alternate day oral corticosteroid therapy. Result s - Bilateral posterior subcapsular cataract was identified in one gir l who had received several prolonged courses of oral corticosteroids, but was not identified in any other patient. Conclusions - There is no evidence to support the contention that inhaled corticosteroid therap y on its own, or in association with short courses of oral corticoster oid therapy, might cause cataracts. Although children receiving long t erm systemic corticosteroid therapy should be screened for cataracts, this is unnecessary in children on inhaled corticosteroids alone.