Tip of the month
Tip of the month - Children using topical corticosteroids for the treatment of allergic conjunctivitis must have their intraocular pressure regularly checked
Children using topical corticosteroids for the treatment of allergic conjunctivitis must have their intraocular pressure regularly checked

Publishing date: December 2018

Tip Editor: John Salmon
Tip reviewer: Roger Hitchings


30-40% of the population respond to topical steroids by increasing their IOP (1). A steroid response is commonly found in patients with glaucoma. Other risk factors include a family history of glaucoma, diabetes and high myopia (1). Children are particularly susceptible to an IOP increase secondary to steroid eyedrops, with more than 60% exhibiting this response (2).

The reason for this phenomenon is not known, but increased resistance to aqueous outflow through an effect on the extra-cellular matrix or endothelial cells of the trabecular meshwork presumably plays a role (1,2). Children taking topical steroids for allergic conjunctivitis should have their IOP regularly checked to avoid the development of secondary glaucoma and visual loss (3).

Contributor: Frances Meier-Gibbons - Eye Centre Rapperswil - Switzerland



References

1. Dibas A, Yorio T. Glucocorticoid therapy and ocular hypertension. Eur J Pharmacol. 2016; 15:57-71

2. Phulke S, Kaushik S, Kaur S, Pandav SS. Steroid-induced glaucoma: an unavoidable irreversible blindness. J Curr Glaucoma Pract. 2017; 11:67-72

3. Kaur S, Dhiman I, Kaushik S, et al. Outcome of ocular steroid hypertension response in children. J Glaucoma 2016; 25:343-47



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