CORTISONE PUFFERS AND CATARACTS

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I've been using Symbicort for about 10 months and knew that one of the possible side effects of cortisone is cataracts, which I felt was a risk worth taking given that prior to being prescribed Symbicort I was getting very little sleep bc of incessant coughing.   I was initially using it twice in the morning & twice at night but due to bad leg cramps (another common side effect) I cut it back to one inhalation twice a day.    A few months ago I decided to check if the cramps would return if I upped the dose to the original prescription and they didn't, so I've been using it at that higher rate for about 2 or 3 months.

In May I went for new glasses and was told I had the start of cataracts in both eyes, the right eye being more advanced than the left, but not at a stage requiring surgery.    I spoke to my practice nurse, who has post grad pulmonary qualifications, and was told most of the powder in steroid puffers stays in the lungs and wouldn't cause or escalate cataracts.

The right eye cataract is now advanced enough for me to have been put on the urgent list for surgery, which will take place either before xmas or early in the new year.    

The surgeon told me that I have a classic steroid created, fast escalating cataract and that the left eye will have to be done later on when I've recovered from the right eye operation, and that she sees this quite often in patients using steroid puffers for COPD.

I"m not suggesting anyone not use or stop using steroid puffers, just letting others know what's happened to me, because neither my GP nor my practice nurse had heard of it, and I reckon it will become even more common as all us baby boomer ex smokers reach COPD stage.   

 

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  • Posted

    That is a very worrying side-effect I haven't been told about.  I have been on various steroid inhalers over the past few years and am Budesonide via a nebuliser at present.  I went for my eye test the other day and was told I have the start of cataracts in both eyes.  But I assumed it was just an age thing.  Strangely, I have also been having leg cramps at night intermittently.
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    • Posted

      It's on the manufacturer's website and info sheet and so is the leg cramp issue, so I knew about both.  One doctor's comment was that most people are going to get cataracts anyway if they live long enough and I made an informed choice to continue using Symbicort, esp after what the practice nurse told me.  I've now passed on the info from the surgeon to both her and my gp so they can make other patients aware of it.    

      We all need to take responsibility for checking ot possible negative effects of ALL medication we're prescribed and making informed decsions:  I've had gp's who prescribed medication for migraine which the manufacturers specifically warn should NEVER be given to anyone who's had a heart attack, which I have had ... enough said.

      If you're using the puffer twice morning and night, you could  try halving that as I did and see if you get rid of the leg cramps without exacerbating the coughing aspect of your COPD, but it may be too late for your cataracts.    I truly believe that if I'd kept the dose down to half, my cataracts wouldn't have deteriorated as quickly as they have.

       

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  • Posted

    Sorry to hear about your need for cataract surgery Jude.  I've never been on a steroid inhaler, try to just use the Ventolin inhaler once in the morning, some days

    I require a second puff in the a.m.  I was told last year during an eye check-up that

    I too have cataracts forming, also worse in one eye, can't remember which one at

    the moment.  Said they weren't bad enough to require surgery.  Always had poor eyesight, have worn glasses since I was 9 years old.  Think for me it is just an

    age thing most likely.  Good luck with it Jude. x

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    • Posted

      Thanks terri.  Ventolin does nothing for me as I have emphysema, not asthma.   I've worn glasses since I was about 16 and it's going to be very nteresting to only need them for reading after both cataracts have been replaced with plastic lenses.
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    • Posted

      I feel the same way Jude, regarding not having to wear glasses anymore. I have worn glasses since I was 7 years old. I just saw my opthalmologist three days ago, and he said my cataracs will probably be ripe enough for surgery in about one year. He said no one feels any pain, so it is suppose to be painless. It will be nice to have both eyes done at the same time too. My dad had his taken out, and now has perfect vision, and he loves it. Thank you for telling us about the importance of reading the manufacturer information before taking any medications. My doctor refused to give me medication for my migraines, due to high blood pressure, since she said my blood pressure would quickly go shooting out the ceiling. Thank you again! xo 
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    • Posted

      I'm amazed that you're looking forward to both eyes being done as "nice"::  I wuouldn't do that in a fit, but I guess you have someone to look after you in recovery?      Did your Dad have lenses for short or long sight inserted?

      My understanding is that anyone who needs bi or multi-focals will still need glasses for short sightedness, which is what I"ve been told in my case

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    • Posted

      I know that when the time comes, knowing myself, I will probably be up at all hours of the night worrying and worrying before the operation...lol. They say it is usually very painless, and they give us a sedative, and lots of numbing eye drops, and all we see is white with colorful vision, without any pain, as the doctor performs the operation, and that it takes about 20-30 minutes from start to finish, and one week of recovering, and the same one week, before having better vision.

      I do have family with me that will give lots of support, but I usually have to help myself with activities, walking, cleaning, and more. I always tend to look at things in a positive light, because we usually have no choice, but to have to go through the operation anyhow, even though it can be scary.

      Regarding 'nice', I was referring to having better eye sight. It may be inconveniencing having them both done at the same time, but I would rather have them both done, while I have the nerves to do it, and also just to get them both over with. I understand that I can't get them done together at the same time, and they will be separately done, and at different dates, healing one eye at a time, but at least they will be done...lol. 

      My Dad had long vision, and so do I. My Dad and I both can't see far away, but we can see up close. I am not sure if he wears reading glasses or not, because he lives far away from me, and we only have spoken on the phone about his operation. 

      But, I was reading, that due to the more perfect far-away vision, the worse the up-close vision will be. So, after the operation, our eye sight will be near perfect, so guessing we will really need bi-focals then. Hopefully not.  I am not sure if they have lenses that include bi-focals, but if so, that would be nice. I am not sure if we need prescription glasses for up close vision, but only a pair of reading glasses, which can be purchased, over the counter, from most stores.

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  • Posted

    So you're not actually getting both eyes operated on at the same time????
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    • Posted

      No, I don't think they will do that, due to vision problems, while recovering. The operations will be one at a time, one eye, then after recovery, the other eye. But the doctor was only assuming both eyes will be ripened by this time next year. We will have to see, but if so, then they will be done separately, and on different dates. 
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  • Posted

    Hello Jude  Have just come across your posting here about inhalers and cataracts.

    Do you remember me Carol in the UK with the husband with COPD.  I have actually replied to you under my other posting, breath east groups I think it was and have updated you after my husband went to the thoracic clinic.  By the way the diagnosis is asthma/copd because he has elements of both condtions.

    I know you have mentioned waiting for cataract surgery.  I hope that you have one eye done by now or at least are having it done this month.  I wish you a good outcome.  I may have mentioned that I too have had 2 cataracts removed 2012 and 2014.  I was told they were posterier type which usually affect younger people and progress sooner that the common aged related ones.  Like you I knew about the risks of puffers and cataracts and glaucoma.  I have taken inhales since 2002 and symbicort  much of this time.  I assume this is why the cataracts developed and incidently I am being treated for glaucoma in one eye although but we do have that in the family.  I was interested to hear that symbicort can cause leg cramps this is something my husband complains of on one or two mornings.

    You are right patients should be made aware of the problems inhalers could cause.  

    I wish you well and hope that you will soon be seeing well.  Look forward to hearing from you soon.

    Carol

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    • Posted

      I've had one cataract removed and a distance corrective lens inserted:  I although I knew the latter procedure was available I assumed it was only for rich people or those with private health cover, but it was all free on our public health system ....... which isn't perfect, but sometimes is close to it, as in this case.

      I find it amazing to be able to drive without glasses for the first time in 40 years and I can sew again and read for more than 5 or 10 minutes at a time.

      The surgery (exactly a month ago now) was successful and the other eye, which isn't anywhere near as bad, will probably be done in the next couple of months and I guess that will transform my world even more!

      .   

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    • Posted

      Nice to hear from you, so glad everything went well with your surgery.  I as you know had mine done the NHS and I was not asked about the type of lens they would put in.  Maybe as you say distance lens are only available privately not on the NHS, although I only need glasses for reading.  Perhaps if someone has poor distance vision then they will get a distance corrective lens.  Maybe someone else can tell us.  

      Yes it is lovely to be able to see properly.  I remember the day after surgery with my first eye everything seemed so fresh and bright.  It is good you can drive without glasses and sew again.

      It won't belong until you have the other eye done so expect your vision to be even better.  Good Luck.

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    • Posted

      To clarify, I'd worn multifocals for decades and now only need over the counter magnifying spectacles for reading & close work, which don't of course quite suit the eye that hasn't been operated on yet, but it's still a vast improvement while I wait for the second operation.

      The only real drawback is that I haven't worked out how I can read outside in the sun, but maybe at some stage I can get magnifying sunglasses for that.

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    • Posted

      You will probably need sunglasses outside until the eye settles and heals.

      I was told it happens to most people.  It is good you now only need over the counter specs for close work.

       

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    • Posted

      Happy for you Jude.  Seems that the health care systems in the Uk and Australia are far surperior to the one we have here in Canada.  Think that some people are under the mistaken impression that we have a good system in Canada, not so.  Glad to hear that your vision is so much better Jude.  Have an appointment to see the eye Doc. in the next week as he saw the beginning of a cataract in one or could have been both of my eyes, can't remember exactly.  Were you on your own when you recuperated?  Thinking if surgery is needed on mine I should be ok with just doing one eye at a time to recupe on my own.  x
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    • Posted

      Yeah, I was told to wear sunglasses outside all the time for a couple of weeks after the surgery:  I'm talking about longterm not being able to read outside with ordinary sunglasses because I'm still short-sighted.
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    • Posted

      My impressionis that Canada has a good reputation on public health because it's still far superior to your big southern neighbour.

      As far as I know, one eye is always done and then the other at least 8 weeks later.    I was told not to drive the car, bend forward or lift anything heavy until I'd been for a checkup a week later and to use two lots of eyedrops (antibiotic & cortisone) four times a day for 4 weeks.

      I was fine recuperating on my own and fortunately there were no complications, because the hospital is a 2 hour drive away   

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    • Posted

      Hey Jude (just had to put that!):

      Thanks for the info.  Yes, a lot of people have the "impression" that we here in Canada have an excellent health care system and it just isn't the case unfortunately.  It is better than the States, but still not as good as the UK or what  you people have.  Take care. x

       

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    • Posted

      Yes sorry I did mean only short term for the sunglasses outside, although because I already suffered from blepharitis and light sensitivity I had a problem for months and still do to some extent.  Will you not be able to get prescription sunglasses for reading outside long term.
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    • Posted

      I'll ask about it at my next appointment.   I was VERY sensitive to light, particularly car headlights, which virtually prevented me from driving at night until I had the first cataract removed.  I'm still slightly sensitive but am assuming removal of the second cataract will rectify that.
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