Cortisone, Cataracts, and Glaucoma, Oh My!
How many of you are fighting another chronic disease as well as your macular degeneration? Something that requires medications such as cortisone which may impact the state of your eyes. Did you know cortisone could be the cause of cataracts? Or glaucoma? I didn’t. I have the triple whammy; arthritis, allergies, and eczema. Three problems helped by cortisone, the miracle drug. I had had one injection, in my arthritic hip; one seven day course of the lowest oral dose and topically on a rather regular basis. Was this enough to be a problem?
My macular degeneration diagnosis
For those who’ve read my first story on MacularDegeneration.net, you’ll know about my early diagnosis of cataracts and AMD. For those who haven’t, here’s a quick recap:
In my late 50s, at an optometrist visit for a prescription for new glasses, I was surprised by a diagnosis of cataracts, which led to an appointment with an ophthalmologist and a diagnosis of early macular degeneration as well. But today I want to concentrate on what I’ve learned about steroid-induced cataracts and glaucoma.
Cortisone and cataracts
At my initial visit, I was a little puzzled when the ophthalmologist questioned me about my cortisone use. It turns out cortisone has more side effects than thinning the skin and decreasing bone density, as I had once thought. No one had mentioned it could have an effect on my eyes, and those were the days when Dr. Google was still an intern. But I did learn how he knew. A cataract isn’t simply a cataract, there are differences.
Types of cataracts
There are three types of cataracts:
- Nuclear is the more common type in the elderly, and slow-growing.
- Cortical; which forms in the lens cortex is common in diabetics.
- Finally, the kind caused by cortisone is called posterior subcapsular, which forms at the back of the lens and tends to develop more quickly. Another cause though is extreme farsightedness.
It’s thought that a diet high in antioxidants may help in small part, although my diet has always been high in them. But in the long run, all three kinds will likely need surgery at some point.1
Cortisone and glaucoma
Another less common eye problem that could be caused by steroids is secondary glaucoma. If you’re on steroid medication for another condition, and as this open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is important to have this checked at every eye exam. If unrecognized, the steroid response can develop into steroid-induced glaucoma and cause permanent optic nerve damage. But it is important to know this ocular hypertensive response is fairly reversible if intervened at the right time. It’s just a matter of discontinuing the steroids. But then, what else is there that works? In fact, every week of steroid use averaged over a lifetime leads to a 4% increased risk of chronic steroid glaucoma.2
Sharing what I learned
This isn’t meant to add to your anxiety, just to share what I wish I had known many years ago, when I became one of the unlucky few with steroid-induced cataracts. Most of us with age-related macular degeneration have reached an age where we’ve become very careful with what goes in or on our bodies, but sometimes it’s difficult to determine what that is. Do you have another chronic condition as well that makes dealing with your macular degeneration even more difficult?
Do you still drive?