Corticosteroids and cataracts: how to minimize damage to vision

14/09/2025

Corticosteroids, commonly called corticoids, are among the most widely used medications in ophthalmology and general medicine because of their powerful anti-inflammatory effect. However, their prolonged use can lead to complications, including ocular cataracts.

What are corticosteroids?

Corticosteroids, or corticoids, are drugs derived from cortisol, a hormone produced in the adrenal glands that participates in numerous physiological mechanisms such as:

• Inflammation
• The immune system
• The metabolism of carbohydrates and proteins
• The balance of electrolytes in the blood

Functions of corticosteroids

Anti-inflammatory and immunosuppressive effect

At the pharmacological level, their anti-inflammatory and immunosuppressive effect stands out. For this reason, they are used when a strong and rapid action is required against severe inflammatory processes.

These medications are very useful, but because of their potential adverse effects, they must always be used under medical supervision.

Side effects of corticosteroids

The side effects of corticosteroids administered systemically depend on the dose and duration of treatment. Therefore, their use should follow these principles:

• Very precise medical indications
• Use for the minimum time necessary
• Gradual withdrawal according to medical prescription

Main side effects

The most frequent include:

• Immunosuppression, with increased risk of infections
• Gastritis
• Bone demineralization
• Alterations in body fat distribution
• Alteration in glucose metabolism
• Ocular complications such as cataract development

Cataracts caused by corticosteroids

Characteristics

Cataracts induced by corticosteroids usually differ from age-related (senile) cataracts. They are known as posterior subcapsular cataracts, which present as an opacity in the posterior area of the lens.

Impact on vision

These cataracts may appear earlier and more intensely, especially affecting:

• Near vision
• Tolerance to bright lights, causing glare

Treatment

As with other types of cataracts, the treatment is surgical.

Topical or systemic corticosteroids can have important adverse effects on eye health, such as glaucoma and cataracts. The risk depends on the dose and duration of treatment. For this reason, it is essential that their use remains under specialized medical supervision.

If you are undergoing corticosteroid treatment, schedule an eye examination at the Barraquer Clinic to prevent adverse effects and protect your vision.

Frequently asked questions about corticosteroids and cataracts

1. What type of cataract do corticosteroids cause?
   They are usually posterior subcapsular cataracts, with rapid deterioration of near vision and glare.
2. Do they affect distance vision or only near vision?
   They begin by affecting near vision and may progress to affecting overall vision.
3. Can corticosteroids be discontinued?
   Only under medical supervision. Stopping them abruptly can be dangerous.
4. Is cataract surgery different in these cases?
   No, the procedure is the same as for senile cataracts; only the timing of the indication changes.
5. How often should I have my eye pressure checked?
   At least every 3–6 months during prolonged treatment.
6. Are there alternatives to corticosteroids?
   Yes, such as immunomodulators, which help reduce dependence on corticosteroids.
7. Do intravitreal injections increase the risk?
   Yes, they can cause cataracts and even infection if not performed under aseptic conditions.

Dr. Andrés Picó, ophthalmologist at the Barraquer Ophthalmology Centre