Ocular Surface, Intraocular Pressure and Lens Condition in Bronchodilator and Steroid-Treated Patients with Chronic Pulmonary Disease.

OBJECTIVES: The aim of this study was to investigate ocular surface, intraocular pressure and lens condition in bronchodilator- and steroid-treated chronic pulmonary disease patients.

METHODS: In this cross-sectional clinical study, 101 patients with chronic pulmonary disease were treated with an inhaler and/or nebulized therapy for bronchodilatation. The patients were evaluated in 2 groups namely chronic obstructive pulmonary disease (COPD) and asthma. We investigated the effects of patient demographic characteristics, smoking, and medications on the presence of dry eye disease (DED), intraocular pressure, and cataract.

RESULTS: Patients had a mean age of 66.4 ± 11.9 years, and 46.5% (n = 47) were female. A unit increase in the length of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) combination use was associated with a 1.02-fold increase in cataract risk (OR: 1.02, CI: 1.01-1.04, p = 0.016), and current smokers had 10.8 times as many cataracts (OR: 10.79, CI: 1.70-68.30, p = 0.011). Patients who used a nebulized corticosteroid had a 9.15 times higher risk of developing dry eyes than those who did not (OR: 9.15, CI: 2.34-35.75, p = 0.001). In patients using ICS-LABA, in comparison to formoterol beclomethasone, salmeterol fluticasone was found to increase the risk 7.49-fold for DED (OR: 7.49, CI: 1.48-35.75, p = 0.015).

CONCLUSIONS: Nebulizer delivery of steroids is associated with dry eye and cataracts. Smoking, ageing, and long-term inhaled steroid use have all been linked to an increased risk of cataracts. Longitudinal and larger sample size studies are needed to explore cause-effect relationships.