Steroid Glaucoma

Question 1

What are corticosteroids used to manage?

Answer 1

Inflammatory diseases

Question 2

Give 2 examples of a disease that corticosteroids are used to manage?

Answer 2

Uveitis and rheumatoid arthritis

Question 3

What is a side effect of steroid use?

Answer 3

A raise in iop

Question 4

What is the estimated amount that steroids increase iop?

Answer 4

35%

Question 5

What is the estimated amount that the iop raises by with users of steroids?

Answer 5

A moderate increase by 6-15mmHg however some show a larger increase by over 15

Question 6

By which mechanism does steroids increase iop?

Answer 6

By reducing the outflow of aqueous via the trab

Question 7

If the iop in a px that has glaucoma develops quickly, what are they suggestive to have?

Answer 7

an iop that’s likely to be over 30

Question 8

What other conditions does steroid use cause/accelerate?

Answer 8

Cataract

Question 9

If a px is using steroids regularly, what should they have?

Answer 9

They should have monitoring on a monthly basis and if there’s an increase of iop then they need to be referred urgently

Question 10

If the px who is taking steroids is referred, what is the treatment/advise their given?

Answer 10

They can be stopped from using the steroids and given an alternative one and iop will reduce and go back to normal

Question 11

What is the issue with premature cessation of steroids?

Answer 11

The px is expected to use the steroids continuously to control the original disease but premature cessation could lead to a risk of a flare up of the original disease

Question 12

Rather than premature cessation, what else could be done when the px is treated using steroids?

Answer 12

They could use the steroids for the original disease and be prescribed iop lowering meds to treat the raised iop and protect from glauc damage