Topical, periocular and intravitreal steroids can all raise intraocular pressure in some patients, and the rise can be silent. Measure pressure at baseline and within the first weeks of a steroid course, and again if treatment continues.
Patients with glaucoma, a family history or a previous rise on steroids need earlier and more frequent checks. Give the patient the planned end date for the course so that treatment does not continue by default.
- Record baseline pressure before any steroid course.
- Re-measure within the first weeks, then at intervals while treatment continues.
- Check earlier in glaucoma, family history or previous steroid response.
- State the stop date at the first prescription.
Why it matters
Steroid-induced pressure rise is often silent until the optic nerve is already affected.
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