Topical corticosteroids can raise intraocular pressure in a proportion of patients, usually within two to six weeks, and the rise is often silent. People with glaucoma, high myopia, diabetes or a family history of glaucoma, and children, are more likely to respond.
After cataract surgery, uveitis treatment or any prolonged course of steroid drops, measure intraocular pressure at follow-up. Steroid drops dispensed over the counter for red eyes are a common cause of undetected steroid glaucoma in India.
- Measure intraocular pressure within a few weeks of starting topical steroids
- Take extra care in patients with glaucoma, high myopia or diabetes, and in children
- Ask every patient with raised pressure about steroid drops, inhalers or creams
- Use the lowest effective steroid strength and stop as soon as possible
Why it matters
Steroid-induced glaucoma is preventable but painless until vision is lost.
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