Photo : TDM
A recent study conducted by six researchers from the First Capital University of Bangladesh has shed light on the alarming prevalence of cataracts among patients with rheumatic diseases, raising concerns about the long-term use of steroids in managing these conditions. The study, titled "Prevalence, types, and risk factors of cataracts in patients with rheumatic diseases," published in the Asian Journal of Research and Reports on Ophthalmology on June 20, 2023.
Rheumatic diseases, including gout and rheumatoid arthritis, can wreak havoc on the immune system, leading to severe pain, redness, swelling, and inflammation in various parts of the body, including the groin. The study found that patients suffering from these invisible diseases often experience prolonged agony, with arthritis pain persisting over time.
Doctors, faced with the challenge of managing these painful conditions, sometimes resort to prescribing steroids as a replacement therapy when painkillers prove to be ineffective. While steroids provide immediate relief, the study revealed a troubling trend of patients self-administering short-term steroids without proper guidance. This reckless use of steroids has been linked to the development of cataracts, which can ultimately increase the risk of blindness.
The study involved extensive data collection on disease history, steroid use and cataract development of patients seeking treatment at the Rheumatology Department of Rajshahi Medical College Hospital. Data collection was done from December 2021 to May 2022.
The study, which involved 112 patients seeking treatment at the Rheumatology Department of Rajshahi Medical College Hospital, revealed some concerning statistics. Of the patients, 43 individuals, aged between 40 and 59 years, were found to have cataracts, constituting 52.7 percent of the total affected. Furthermore, 72.1 percent of those who had been treated with steroids for more than 5 years had an increased incidence of cataracts.
Head of the Ophthalmology Department at RAMEC Hospital, Dr. Md Yusuf Ali confirmed that long-term steroid use is indeed a known cause of cataracts. He emphasized the importance of educating patients about the proper use of steroids and the potential side effects.
Patients like Siddique Ali (75) and Akram Ali Pramanik (65) shared their experiences at RAMEC Hospital. Siddique Ali, suffering from rheumatism for nearly a 30 years, unknowingly developed cataracts while seeking relief for arthritis. Akram Ali Pramanik, who once enjoyed sports, found himself grappling with cataracts after a traumatic incident 30 years ago. Both patients highlighted the crucial role of early diagnosis and intervention.
Head of the Rheumatology Department at Rajshahi Medical College Hospital, Dr. Asif Hasan said, “According to international guidelines, steroids should not be used for more than three months and should be considered a topical treatment. For this, first of all, it is necessary to inform the patients about the function of the medicine and how long it should be taken. But most doctors don't.”
He also said that taking steroids for a long time disrupts the release of normal steroid hormones in the body. At some point the patient becomes dependent on steroid drugs. It causes diabetes, high blood pressure, ulcers, osteoporosis, muscle weakness, cataracts and decreased immunity. Awareness is important to prevent.
The study's findings have prompted calls for greater interdisciplinary collaboration between rheumatologists and ophthalmologists. Routine eye examinations are being encouraged for rheumatoid arthritis patients undergoing long-term steroid therapy. Researchers also urge further investigations to deepen understanding of the mechanisms underlying ocular involvement in rheumatic diseases.
TDM/SD
