Any one know of Cataracts and MS not caused by steroid use ??

[lynnkay4]

I was just at my opthamologist office and he said I had cataracts in both eyes, but not the kind I would expect, it's the kind you can get when using steroids or some medications. He says it's often seen in people with MS . I explained that I can't take steroid.

I have never heard of this before and wanted to check in here to see what I could find out.

Thanks for any information you may have.

Lynn

[SNOOPY]

Redwings is the best person to answer this question but in the mean time:

There can be different causes to developing cataracts and they are not necessarily related to this disease:

http://www.allaboutvision.com/conditions/cataracts.htm

I have congenital cataracts in both eyes.

[Shashi]

I had the same type of cataracts that you probably have (posterior subcapsular cataracts.) My neuro-ophthalmologist told me that they were probably from the one and only dose of steroids I have ever taken. (Lucky me!)

There are other things that cause these types of cataracts too though, such as long-standing myopia (nearsightedness), diabetes, higher salt intake, smoking, blood coagulation factors, and kidney disease. (I have had myopia since I was in my 20s, so mine may be from that instead.)

I had the one in my right eye removed back in August, and plan to have the one on the left removed around Christmas time if it's ready to come out (which I think it is.) I've done well after the surgery, except it's kind of strange that my "new eye" is farsighted and my "old eye" is still nearsighted.

I'm also having trouble right now with blurring after focusing on my computer or reading for more than 20 to 30 minutes at a time. I have an appointment to get that checked out in two weeks. (I think that might be related to the double vision I have though.)

[Shashi]

Oh, Snoopy's post reminded me, I also have congenital cataracts in both eyes. My ophthalmologist said they look like little stars or flecks in my lenses. They aren't supposed to cause any problems. But the other ones sure have!

[SNOOPY]

I also have congenital cataracts in both eyes. My ophthalmologist said they look like little stars or flecks in my lenses. They aren't supposed to cause any problems.

I don't know Shashi, my vision sucks because of the cataracts.

[Shashi]

It's just my congenital cataracts, Snoopy. Mine weren't supposed to cause me any problems, but the other ones sure did! Yours may be different.

I had an ophthalmologist tell me one time that my congenital cataracts were so pretty, and that they looked like a Christmas tree. I also had one tell me that I had the type of cataracts that people with muscluar dystrophy have. Wonderful.

[SNOOPY]

I had an ophthalmologist tell me one time that my congenital cataracts were so pretty, and that they looked like a Christmas tree.

Of course Congenital cataracts are vivid in color.

I asked my Ophthalmologist a few years ago if the cataracts were removed would my vision be less cloudy and more clear...the answer was yes.

[Redwings]

Hi lynnkay:
There's no such thing as an "MS cataract." There's nothing about the way MS works that directly causes a cataract, and nothing unique about cataracts from secondary causes that identify them specifically with MS. In my years of research, I've never found anything in the medical literature to even suggest that there is.

I've seen a few forum posts over the years where someone said something like, "my eye doctor looked at my eyes and said I have a cataract and knew I had MS." As with so many things posted on forums, the person's assumption is false and/or there's a lot of other information missing.

There are cataracts that are caused by something else that's associated with MS (e.g., intraocular inflammation and steroid use), but none of those secondary causes are unique to MS. A steroid-induced cataract in someone with rheumatoid arthritis looks the same as a steroid-induced cataract in someone with MS. So it isn't possible for a doctor to see that kind of cataract and know what disease is responsible for the need for the steroids that led to the cataract.

As with many things in life, there are genetic predispositions to some things, and cataracts fall into that category. While not common, cataracts of various kinds develop in people in their 40s who don't seem to have any other contributory factors. That may or may not have any connection to other genetic factors that predispose someone to, say, MS. The coincidence of those factors is very individual, and the genetics haven't been unraveled yet. It gets even more complicated when the contributions of environmental exposure get added in, because those can't always be known or quantified, either.

Looking at the situation from the opposite direction, did the individual's combined genetic and environmental history lead to the early development of the cataract? Yes, but those factors are often impossible to identify and quantify. The causative factors of MS aren't even known, yet, let alone how those causative factors could then contribute to a cataract. And that's another reason why it's impossible to look at a cataract and say that it's due specifically to MS.

As far as congenital cataracts go, there are different kinds, and their effects on vision depend on what kind they are and how large they are. As to congenital cataracts being vivid in color, I'll say this. The ones that are colorful are colorful. The ones that aren't, aren't. And most congenital cataracts are not vivid in color. Congenital "christmas tree" cataracts are not common.

[SNOOPY]

As to congenital cataracts being vivid in color, I'll say this. The ones that are colorful are colorful. The ones that aren't, aren't. And most congenital cataracts are not vivid in color.

I assumed all congenital cataracts were vivid in color, I now know my assumption was wrong. My cataracts are colorful. My cataracts have been an interest for many doctors through the years. I have even had Drs invite other Drs. in to look at them and I have been told they are beautiful

[Redwings]

My cataracts have been an interest for many doctors through the years. I have even had Drs invite other Drs. in to look at them and I have been told they are beautiful

The multicolored, iridescent cataracts really are beautiful. And their rarity adds even more to the experience of seeing them. That's why even doctors are impressed with seeing them. So for folks who have them, they really are "gems."

I have yet to see an online photograph of a christmas tree cataract that does them justice. This is the closest I've seen so far: http://www.bmj.com/content/341/bmj.c6644?tab=full. A photo can't show their color-changing iridescence. I would have thought that, with digital video being available now on biomicroscopes, there would be videos of them online. Popular, well-identified information comes up in searches pretty quickly, and nothing came up. I'm surprised that I didn't find even one video.

SNOOPY, if you can get your ophthalmologist to make a video of your cataracts, you could put it on YouTube and become an Internet celebrity!

Steroid-induced cataracts, like Shashi and I have, and apparently like the kind your ophthalmologist found, lynnkay, are posterior subcapsular cataracts. (Like the name suggests, they occur at the back side of the lens, just inside the outermost, enclosing layer.) There are photos of them online, but I couldn't find one to link to that wouldn't take a bit of explanation to sort the PSC out of other things in the lens. If you look at a bunch of photos, you can probably get an idea for what one looks like. Especially when compared to christmas tree cataracts, PSCs are pretty unspectacular.

[SNOOPY]

The multicolored, iridescent cataracts really are beautiful. And their rarity adds even more to the experience of seeing them. That's why even doctors are impressed with seeing them. So for folks who have them, they really are "gems."

It has been obvious to me, due to reacts by Opthamologists/Optometrists that the kind I have are rare and I have been told that.

The cataracts may look beautiful to those looking from the outside in but as someone who is looking from the inside out there is no beauty to be found

The pictures from the URL were awesome, thanks for posting it. I have never had my cataracts referred to as a christmas tree cataract.

[Shashi]

Ah, so that's what my ophthalmologists meant by my congenital cataracts looking like a Christmas tree. I always wondered and wished I could see them from their point of view instead of mine. Thanks for the picture, Redwings.

I've seen pictures of posterior subcapsular cataracts. They're very dull looking compared to that picture of the Christmas tree cataract. After I had the cataract in my right eye removed, I was complaining to the neuro-ophthalmologist about the glare I was experiencing in my "new" eye, and he told me that the cataracts kind of act like natural sunglasses. Once they're gone, you don't have that glare-reduction benefit. (My glare-free lenses on my glasses took care of that though.)

[quietposter]

My eye doctor recently told me I have cataracts and I am in my 40's. He said it could be from age, the steroids for MS or from the Flonase I was taking. I was surprised by the reference to Flonase and did a little internet research to confirm what he said was in fact true. Had I known either could cause cataracts, I would not have done either. Oh well, live and learn!

[lynnkay4]

Thank you all for your very informative post. Redwings you are so helpful with your research and knowledge and I appreciate you taking the time to help us like you do.

For some reason I didn't write down or remember the type of cataracts he said I had. I am going to call and find out. That's not like me as I normally research any new medications I'm prescribed or new health issues that I experience.

I do know he said if I start seeing burst of lights , like fireworks then I need to call them. He also said this type of cataract grows quickly, some times in 6-9 months a person could need surgery.

Thanks again for your help.

Hugs to you all.