Steroid-Induced Elevation of Intraocular Pressure

Abstract

Introduction It has been recently been suggested that long-term systemic steroids can produce a small elevation of intraocular pressure and a decrease in facility of outflow.¹ The actual appearance of an overt glaucoma in patients on long-term systemic steroid therapy has previously been reported by Stern,² Covell,³ and Harris.⁴ In all five of these patients the intraocular pressure remained elevated despite discontinuation of the steroids and required miotics, acetazolamide (Diamox), and even surgery, for satisfactory control. Therefore, one could not completely rule out the spontaneous appearance of angle-closure or open-angle glaucoma in these patients, unrelated to steroid therapy. François⁵ observed a 35-year-old man, with vernal catarrh, treated for over three years with topical steroids, who developed open-angle glaucoma in both eyes. One eye had a Bjerrum scotoma and required an iridencleisis. The intraocular pressure of the other eye returned to normal eight days after the