ESCRS - PO045 - "The Dark Side Of Easy Access: Non-Prescription Topical Corticosteroids And The Risk Of Cataracts In Adolescents – A Public Health Concern?"

"The Dark Side Of Easy Access: Non-Prescription Topical Corticosteroids And The Risk Of Cataracts In Adolescents – A Public Health Concern?"

Published 2025 - 43rd Congress of the ESCRS

Reference: PO045 | Type: Case Report | DOI: 10.82333/sc6c-r473

Authors: Maria Andrea Estevez Florez 1 , Fernando Godin Estrada* 2 , Maria Adelaida Piedrahita Botero 1 , Franco Battaglia 3 , Arturo Enriquez Garza 4

1Cundinamarca,Universidad El Bosque,Bogotá,Colombia, 2Cundinamarca,Clínica Oftalmológica COLSUBSIDIO ,Bogotá,Colombia, 3Mar del Plata,Hospital Privado de Comunidad,Mar del Plata,Argentina, 4Nuevo Leon,Clínica de Ojos Monterrey,Monterrey,Mexico

Purpose

To report a case of a 16-year-old female patient with bilateral posterior subcapsular cataracts associated with topical corticosteroid overuse.

Setting

Clínica Oftalmológica COLSUBSIDIO, Bogotá DC, Colombia

Report of case

A 16-year-old female patient presented to the cornea service with a decrease in visual acuity in both eyes, which had persisted for several months. This was associated with self-medication using topical corticosteroids for over 10 months, primarily for repeated ocular allergies, as reported by the mother. Physical examination revealed uncorrected visual acuity (AVSC) of OD: 20/400 and OS: 20/400, with correction using a pinhole to OD: 20/40+ and OS: 20/60. Biomicroscopy showed healthy conjunctiva in both eyes, clear cornea, formed anterior chamber, and a posterior subcapsular cataract grade III-IV in both eyes, which compromised the visual axis. The fundus examination revealed no abnormalities, and intraocular pressure was within the normal range.

The patient’s history indicated chronic corticosteroid use without signs of glaucoma, with good potential for visual recovery. Given the high anesthesia risk due to the patient’s age, bilateral cataract surgery was performed. The procedure included implantation of an extended depth of focus lens (RAYONE EMV) and was completed without complications. On the day following surgery, the patient was evaluated with postoperative visual acuity of OD: 20/30 and OS: 20/40.

Conclusion/Take home message

The use of over-the-counter medication in our country is a public health problem. Unfortunately, eye drops containing NSAIDs and/or corticosteroids fall into this category, becoming medications with indiscriminate use. Cataracts secondary to corticosteroid use are common in a hospital inpatient setting or a patient with an autoimmune disease, not common from the use of an eye drop. For this reason, taking into account the patient's age and history, we should always ask about the use of self-medicated drugs.