Vision Threatening Glaucoma with use of Topical Steroids

R Khandelwal, S Gupta


Objectives : To evaluate blindness due to steroid induced glaucoma and grade its severity. Methods : Retrospective case review study included 12 patients out of 268 patients of secondary glaucoma attending Glaucoma Clinic from Jan 2008 - Dec 2010. Secondary steroid induced glaucoma was diagnosed after detailed history and complete eye examination. Results : 20 eyes of 12 patients had steroid induced glaucoma .All patients were young and mean age of presentation was 25.9 +/- 6.5 years (range: 16-36 years). Bilateral involvement was found in more than half cases (58.3%) using topical steroids without intraocular pressure (IOP) monitoring. Blindness (V/A < 3/60 to NPL) was seen in seven eyes (35 %) and visual impairment was noted in nine eyes (45%). IOP in 16 eyes could be controlled with medical anti glaucoma therapy but others needed trabeculectomy with/without MMC to control IOP. Conclusion : Topical steroids are a double edged sword and should be used judiciously with regular followup .High proportion of patients are 'steroid-responders', and are at risk of pressure spikes, leading to irreversible loss of vision from optic nerve damage. Key Words: steroids, secondary glaucoma, allergy

Full Text: