Corticosteroid-Induced Glaucoma

Abstract

Corticosteroid use has been found as a risk factor for ocular hypertension and glaucoma since 1950s. The effect of corticosteroids on intraocular pressure varies depending on their chemical structures, potency, ability to penetrate ocular tissue, dosage, duration, and routes of administration. Individuals with primary open angle glaucoma or family history, or with certain ocular and systemic disorders, are more susceptible to corticosteroid-induced ocular hypertension and glaucoma. Increased resistance and decreased outflow facility at the trabecular meshwork secondary to extracellular and intracellular alterations after corticosteroid use have been considered the main mechanism of intraocular pressure elevation. While the clinical course and findings of corticosteroid-induced glaucoma are similar to primary open angle glaucoma, the most effective treatment of this particular secondary glaucoma is discontinuation of the drug. Judicious selection of appropriate formula with careful monitoring is vitally important to reduce the risk of corticosteroid-induced glaucoma.