Corticosteroids and Glaucoma Risk

  title={Corticosteroids and Glaucoma Risk},
  author={Ramesh Chandra Tripathi and Sunil K. Parapuram and Brenda J. Tripathi and Yong Zhong and Kakarla V. Chalam},
  journal={Drugs \& Aging},
Corticosteroids (glucocorticoids), used frequently as potent anti-inflammatory agents, increase the risk of glaucoma by raising the intraocular pressure (IOP) when administered exogenously (topically, periocularly or systemically) and in certain conditions of increased endogenous production (e.g. Cushing’s syndrome). Approximately 18 to 36% of the general population are corticosteroid responders. This response is increased to 46 to 92% in patients with primary open-angle glaucoma (POAG… 

Increased Risk of Ocular Hypertension in Patients with Cushing's Disease.

An increased risk of ocular hypertension was seen in patients with Cushing's disease and suggests that endogenous hypercortisolemia should be considered as part of the glaucoma assessment.

Commentary: Blindness from glaucoma associated with steroid abuse in children

Although prolonged and sometimes indiscriminate use of steroids causes IOP rise and glaucomatous visual field loss, it is not unknown to encounter significant IOP elevation within hours of use, and this adverse effect of steroid use may not be reversible in certain susceptible individuals.

Steroid glaucoma

The tactics of treating patients with ocular hypertension or a proven case of steroid glaucoma, and the pathogenesis of an increase in the level of intraocular pressure against various forms of glucocorticosteroids intake are described.

[Drug-induced glaucoma].

In cases when the patient's IOP does not normalize after discontinuation of steroids or when they must continue to take corticosteroids, the administration of topical drugs for the treatment of glaucoma should be considered.

A review of systemic medications that may modulate the risk of glaucoma

This review provides a summary of reported associations between different systemic medications and the risk of developing glaucoma or experiencing disease progression.

Inhaled corticosteroids: Ocular safety and the hypothalamic-pituitary-adrenal axis.

  • W. CarrS. Szefler
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2016

Intraocular Pressure Effects of Common Topical Steroids for Post-Cataract Inflammation: Are They All the Same?

The proportion of patients exhibiting an increase of ≥10 mmHg IOP in clinical studies has emerged as the most clinically relevant parameter for ophthalmologists to consider when deciding on which topical corticosteroid to use.

Cutaneous corticosteroid-induced glaucoma

The ability of certain topically applied corticosteroids to raise intra-ocular pressure (IOP) in susceptible individuals, particularly in open angle glaucoma patients, require care in the ophthalmologic and dermatologic practice.

Corticosteroids and Open-Angle Glaucoma in the Elderly

None of the classes of steroids were associated with the incidence of OAG in this elderly population, and associations between the use of corticosteroids and incident OAG were assessed using logistic regression models.

Visual loss caused by corticosteroid-induced glaucoma: how to avoid it.

The only clinical significance of steroid-induced elevation of intraocular pressure in response to corticosteroids is that such elevation of IOP may, in some cases, lead to nerve damage and cause visual disability, decreasing the quality of life.




The present study was undertaken to determine the effect of topical corticosteroids in the eye with primary open-angle glaucoma, and found that patients on long-term systemic Corticosteroid therapy showed significantly higher mean applanation pressures.


This brief report is presented to alert physicians to the large and significant increases in intraocular pressure observed in so many of the patients studied.

Cellular sensitivity to glucocorticoids in patients with POAG. Steroid receptors and responses in cultured skin fibroblasts.

The results suggest that a generalized cellular hypersensitivity to glucocorticoids is not intrinsic to POAG, and it is possible that environmental alterations and/or endogenous factors may influence the steroid responses observed in these patients.

Ocular toxicity of prednisone in pediatric patients with inflammatory bowel disease.

It is proposed that the mechanisms for steroid-induced lens opacities and raised IOP do not share the same genetic basis and should be advocated for careful ophthalmologic monitoring of pediatric patients receiving corticosteroids for IBD or any other condition.

Treatment of Glaucoma with 3α,5β-Tetrahydrocortisol: A New Therapeutic Modality

It is demonstrated that 3α,5β-THF, a naturally occurring steroid metabolite, is effective in lowering IOP in patients with POAG, and may represent a new therapeutic modality for the management of POAG.

Inheritance of dexamethasone hypertension and glaucoma.

It was shown that glaucoma does not represent a homogeneous single group with respect to the dexamethasone hypertensive response and that it could not be described exclusively by P H P H , instead it showed in addition P L P H and P L L P L as well.

Increased plasma noncortisol glucocorticoid activity in open-angle glaucoma.

Open-angle glaucoma may be associated with a disturbance of the hypothalamic-pituitary-adrenal axis that produces increased plasma levels of both cortisol and other noncortisol glucocorticoids.