Inhaled steroids linked to cataracts.

There's troubling news for the 14 million asthmatics in the United States. An Australian study of 370 older people who have used corticosteroid inhalers, the standard inhaler to ward off asthma attacks, finds that these patients have a significantly heightened risk of developing cataracts, opaque spots in the eye.

Past studies have linked the appearance of cataracts to use of oral steroids, but research on inhalers has been less clear. In a 1995 study, none of 96 children who had used inhalers for an average of 5 years had cataracts. A 1996 study of young people found no link between use of inhalers and posterior subcapsular cataracts, the most common type needing surgery.

The Australian study reaches a different conclusion. It shows that these serious cataracts are three times more prevalent in people age 49 to 97 who use inhalers than in nonusers. People who use inhalers are also more likely to develop the less serious, but more common, nuclear cataracts, which cloud the central part of the lens, Robert Cumming of the University of Sydney and his colleagues report in the July 3 New England Journal of Medicine. The biology underpinning how corticosteroids cause cataracts remains unclear.