Corticosteroid eye drops raise intraocular pressure in a proportion of patients, known as steroid responders, typically within weeks of starting. The risk is higher with more potent steroids, frequent dosing, pre-existing glaucoma, high myopia and in children. Check pressure within a few weeks of starting topical steroids and regularly while they continue, particularly after corneal surgery and in uveitis. Where pressure rises, consider a less potent steroid, tapering, or pressure-lowering treatment.
- Check intraocular pressure within a few weeks of starting topical steroids.
- Monitor more closely in patients with glaucoma, high myopia, and in children.
- Consider a lower-potency steroid or taper if pressure rises.
- Pair any long-term topical steroid prescription with a plan for pressure checks.
Why it matters
Steroid-induced pressure rises are silent and can cause glaucomatous damage before symptoms appear.
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