Are there any studies that address the long-term effects of steroid nasal sprays? I have heard that prolonged use is associated with macular degeneration.—ERIN PROKOP, MS, CRNP, Joppa, Md.

I could not find any data supporting this concern. There is a clinical suspicion of an increase in the incidence of cataracts in long-term nasal steroid users, but a large study in Britain found association only with oral or inhaled steroids ( J Allergy Clin Immunol. 2000;105:912-916). Judging from some of the patient questions I receive, this is an area of confusion that clinicians need to be clear about.—Sherril Sego, FNP-C, DNP (140-1)