Evaluation of Cataract Development in Patients on Chronic Steroid Therapy for Respiratory Diseases

Abstract

Background: Chronic corticosteroid therapy remains a cornerstone in the management of respiratory diseases such as bronchial asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases. However, prolonged steroid exposure is associated with ocular complications, particularly cataract formation.
Aim: To evaluate the prevalence and pattern of cataract development among patients receiving long-term steroid therapy for respiratory diseases.
Methods: This retrospective study was conducted at Government Medical College and Hospital, Purnea, Bihar, from April 2025 to March 2026. Medical records of 105 patients with respiratory diseases receiving corticosteroid therapy for at least six months were reviewed. Data regarding demographic characteristics, respiratory diagnosis, duration of steroid therapy, route of administration, and cataract status were analyzed.
Results: Among 105 patients, cataracts were detected in 42 (40.0%) cases. Posterior subcapsular cataract (PSC) was the most common subtype (57.1%). Cataract prevalence increased significantly with steroid duration exceeding three years (p<0.001). Patients receiving combined inhalational and oral steroids exhibited a significantly higher risk of cataract development than those receiving inhalational steroids alone (p=0.012).
Conclusion: Long-term steroid therapy is significantly associated with cataract formation, particularly PSC. Duration and cumulative exposure to corticosteroids are important risk factors. Regular ophthalmologic screening should be incorporated into the management of patients receiving chronic steroid therapy.