Acute irreversible corticol cataracts in prolonged topical corticosteriod overuse for chronic eczema
2008; Springer Nature; Volume: 23; Issue: 4 Linguagem: Inglês
10.1038/eye.2008.123
ISSN1476-5454
AutoresDawn A. Sim, Rita Chen, Martin ten Hove, Sonam Verma,
Tópico(s)Bee Products Chemical Analysis
ResumoAcute irreversible corticol cataracts in prolonged topical corticosteriod overuse for chronic eczema We report a unique case of acute irreversible cortical cataracts associated with chronic overuse of topical (dermal) corticosteroids in eczema. Case reportA 35-year-old gentleman presented with bilateral blurring of vision over 3 weeks.Visual acuity (VA) was 6/9 OD 6/18 OS.Slit-lamp biomicroscopy revealed bilateral cortical cataracts (Figure 1) and no signs of previous uveitis.Intraocular pressure (IOP) were 14 mmHg OD 18 mmHg OS, and Posterior segments unremarkable.Two weeks later, he returned with worsening of his vision.VA had deteriorated to 6/12 OD 6/24 OS with shallow anterior chambers.IOP increased to 18 mmHg OD and 24 mmHg OS.Gonioscopy showed bilateral narrowed angles.Further questioning revealed a background of chronic facial eczema (Figure 1), from age 13, and treatment with hydrocortisone 1% cream tid, on most days over the past 20 years.Treatment was confined to his face as he had only mild eczema elsewhere.There was no previous use of oral, ocular or inhaled steroids, and no history of diabetes or trauma.He was systemically well and blood tests revealed normal inflammatory markers and random blood glucose levels of 4.5 mmol/l.This gentleman proceeded to have uneventful bilateral sequential cataract surgery, with IOP normalization, attaining VA 6/5 in both eyes.
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