A patient treated with steroids may develop glaucoma. This may occur with any formulation (topical or systemic). The increased pressure often reverts if the steroid therapy is discontinued.


Risk factors for developing glaucoma while being treated with steroids:

(1) presence of primary open-angle glaucoma in patient or a first-degree relative

(2) age < 10 years of age

(3) diabetes mellitus

(4) prolonged corticosteroid therapy

(5) high dose steroid therapy

(6) high myopia

(7) history or current evidence of sensitivity to steroids (increase in intra-ocular pressure >= 6 mm Hg)


Recommendations to reduce the risk:

(1) Use alternative anti-inflammatory therapy when possible.

(2) Use the lowest possible steroid concentration.

(3) Treat a patient with steroids for the shortest possible period.

(4) Write prescriptions for limited amounts to minimize unmonitored use.

(5) Monitor the patient during therapy.


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