DESCRIPTIVE STUDY ON THE PREVALENCE OF ALLERGIC KERATOCONJUNCTIVITIS, DRY EYE, AND CATARACT RISK AMONG ASTHMATIC PATIENTS USING INHALED CORTICOSTEROIDS

Abstract

Asthma is a chronic inflammatory airway disease frequently managed with long-term inhaled corticosteroids (ICS). While ICS therapy effectively controls respiratory symptoms, emerging evidence suggests potential ocular complications, including allergic keratoconjunctivitis (AKC), dry eye disease (DED), and cataract formation. However, the prevalence and interrelationship of these ocular manifestations among asthmatic patients using ICS remain underexplored in clinical settings.

Objectives:
To determine the prevalence of allergic keratoconjunctivitis, dry eye, and cataract risk among asthmatic patients on long-term inhaled corticosteroid therapy, and to evaluate associated demographic and treatment-related factors.

Methods:
A hospital-based descriptive cross-sectional study was conducted among 200 adult asthmatic patients (aged 18–65 years) attending a tertiary care respiratory clinic. Participants had been on ICS therapy for at least six months. Data were collected using a structured questionnaire, slit-lamp biomicroscopy, Schirmer’s test, tear breakup time (TBUT), and ocular surface staining. Cataract risk was evaluated using the Lens Opacities Classification System III (LOCS III). Ethical approval was obtained from the Institutional Review Board (IRB No. 2025-046), and informed written consent was secured from all participants. Data were analyzed using SPSS v29 for descriptive statistics and chi-square testing.

Results:
Of 200 participants, 58 (29%) presented with clinical features of allergic keratoconjunctivitis, 74 (37%) had dry eye based on Schirmer’s and TBUT results, and 32 (16%) exhibited early signs of posterior subcapsular cataract (PSC). The prevalence of ocular complications was significantly higher among participants on ICS therapy for more than 3 years (p < 0.01). Females and individuals aged above 45 years demonstrated greater cataract risk. Polytherapy with systemic corticosteroids further increased ocular complication frequency.

Conclusion:
Ocular surface disorders and early cataract changes are relatively prevalent among long-term inhaled corticosteroid users with asthma. Regular ophthalmic screening and patient education regarding ocular side effects are crucial components of comprehensive asthma management.