We assessed the effect of long-term treatment with inhaled budesonide (BUD) on the occurrence of posterior subcapsular cataracts (PSC), bruises and hoarseness in children with asthma. Slit lamp examinations were performed in 157 asthmatic children treated with inhaled BUD at a mean daily dose of 504 microg (range 189-1,322 microg) for 3-6 yrs (mean 4.4 yrs). Measurements were compared with 111 age-matched children with asthma, who had never received treatment of exogenous corticosteroids (control group). The children were examined for bruises, their tendency to bruise and occurrence of voice changes. No incidents of PSC ascribable to BUD treatment were seen. One patient in the BUD group had been diagnosed with PSC before the study and this was still present. There were no statistically significant differences in number of bruises between the two groups (BUD=33, controls=3.2; p=0.70), area covered by bruises (BUD=10 cm2, controls=10.1 cm2; p=0.97), tendency to bruise (BUD=5/10, controls=5/10) or occurrence of hoarseness (BUD=20%, controls=21%; p=0.92). Furthermore, there was no correlation between the occurrence of bruises or tendency to bruise and duration of treatment, accumulated or current dose of BUD. A 3-6 yr treatment of children with inhaled budesonide at an average daily dose of about 500 microg is not associated with an increased occurrence of posterior subcapsular cataract, bruises, tendency to bruise, hoarseness or other noticeable voice changes.