Vol. 1, Issue 1 (2019)
Clinical Analysis of Steroid Induced Glaucoma
Author(s): Dr. B Vijaya Krishnan, Dr. N Vimal Kumar
Abstract: Background: Steroid use has the potential to cause the elevation of intraocular pressure (IOP) without any regard to the form of steroid. This study analyses the various clinical presentation, etiological risk factors, duration and type of steroid used in causing steroid- induced glaucoma. It helps in arriving at the diagnosis and discusses about the various management options in the treatment of steroid - induced glaucoma. The response of selective laser trabeculoplasty in treatment of steroid induced glaucoma patients is also being analysed. Materials and Methods: This prospective study was conducted at Institute of Ophthalmology in 43 patients of established Steroid -induced glaucoma. 68 eyes of 43 patients were taken into study. Results: Steroid induced glaucoma resolved in 17 eyes of 13 patients with their stoppage of steroids and with initiation of medical treatment. In the study group 51% were male 49% were female. Visual acuity was normal (6/6) in 25% (17 eyes) of the cases. Average IOP on presentation was between 21-30mm of Hg (42.6%) in 29 eyes. (41.2%) 14 patients (28 eyes) were on oral steroids. Diabetes mellitus was the major risk factor in this study. The most common reason for steroid induced glaucoma in this study was, following cataract surgery. Average duration of steroid in years, less than 1 year – 41.5% in 27 eyes and above 6 years (13.8%) in 9 eyes. 38 eyes had medical management of glaucoma. Conclusion: The patients who underwent cataract surgery were more affected due to continued application of topical steroids. Post-operative patients who are prone to glaucoma should be prescribed preferably with non-steroidal anti-inflammatory drugs. Plasma cortisol does not correlate clinically in steroid induced glaucoma patients. Selective laser trabeculoplasty helps in short term control of IOP.