Light Sensitivity and Halo Effects After Steroid Eye Drops: What to Know

After using corticosteroids, symptoms such as photophobia, halos, and an increase in rainbow-colored rings may occur?

Hello Doctor, I have posterior subcapsular cataracts and keratoconus (with astigmatism of 275 in the left eye and 200 in the right eye).
On April 13, I visited the clinic due to dry, itchy eyes and blurred vision.
Doctor A diagnosed me with conjunctivitis and prescribed chloramphenicol and Dexamethasone, instructing me to apply it every two hours (I was unaware it was a steroid, and Doctor A did not inform me).
On April 15, I developed a sore throat and mild fever.
By April 16, the itching had improved, but I experienced photophobia and an increase in halos around lights, even becoming sensitive to the light from my phone.
I went to another clinic where my intraocular pressure was measured at 19.
Doctor B said it was just an allergy and advised me to stop using the steroid eye drops, which I did.
On April 19, I visited my usual ophthalmologist for cataract follow-up.
Doctor C performed a slit lamp examination and also concluded it was just an allergy, stating that the photophobia and increased halos were symptoms related to my existing cataracts and keratoconus.
By April 25, the photophobia had improved, and distant vision became clearer, but the halos around lights and rainbow effects persisted.
I would like to ask if it is possible that the steroid drops caused the cataracts to worsen? What tests should I undergo to determine if the cataracts have deteriorated? Thank you!

Ms. Chen, 30~39 year old female. Ask Date: 2024/04/25

Dr. Cai Wenyuan reply Ophthalmology

Observe and see if the symptoms persist; if they do, seek medical evaluation.

Reply Date: 2024/04/25

More Info

Light sensitivity and halo effects after using steroid eye drops can be concerning, especially for patients with pre-existing conditions like cataracts and keratoconus. In your case, it appears that you have experienced a series of symptoms following the use of steroid eye drops, which were prescribed for what was initially thought to be conjunctivitis.
Steroid eye drops, while effective in reducing inflammation and treating certain eye conditions, can have side effects, particularly with prolonged use. One of the known side effects of corticosteroids is the potential to accelerate the development of cataracts. This is particularly relevant for patients who already have cataracts, as in your case. The symptoms you describe, such as increased light sensitivity and halo effects around lights, can indeed be exacerbated by the presence of cataracts.
The halo effect, where lights appear to have a halo or rainbow-like aura around them, is often associated with refractive errors or lens opacities, such as cataracts. In patients with keratoconus, irregularities in the cornea can also contribute to visual distortions, including halos. Therefore, it is plausible that the combination of your existing conditions and the use of steroid drops may have contributed to the worsening of these symptoms.

To assess whether your cataracts have worsened, a comprehensive eye examination is necessary. This typically includes:
1. Visual Acuity Test: This measures how well you can see at various distances and can help determine if your vision has deteriorated.

2. Slit Lamp Examination: This allows the eye doctor to examine the structures of your eye, including the lens, for any signs of cataract progression.

3. Retinal Examination: This involves dilating your pupils to get a better view of the retina and optic nerve, which can help rule out other potential issues.

4. Tonometry: This measures the pressure inside your eye, which is important for assessing overall eye health, especially if you have a history of eye conditions.

5. Optical Coherence Tomography (OCT): This imaging test provides detailed images of the retina and can help in assessing any changes in the eye's structure.

If your cataracts are found to have worsened, the next steps would typically involve discussing surgical options with your ophthalmologist. Cataract surgery is a common and effective procedure that can significantly improve vision and reduce symptoms like halos and light sensitivity.

In the meantime, managing your light sensitivity can involve practical measures such as wearing sunglasses with UV protection when outdoors, using anti-reflective coatings on your glasses, and adjusting the brightness settings on your electronic devices to reduce glare.

It’s also important to communicate openly with your healthcare providers about your symptoms and any concerns regarding the medications you are using. If you feel that your symptoms are not improving or are worsening, seeking a second opinion or further evaluation from a specialist in cataract surgery or a corneal specialist may be beneficial.

In summary, while steroid eye drops can be beneficial, they also carry risks, especially for patients with pre-existing eye conditions. Regular monitoring and thorough examinations are essential to ensure that any changes in your eye health are promptly addressed.

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