Steroid-induced glaucoma in a 6-month-old girl - case report

Abstract

Steroids are a group of anti-inflammatory drugs, commonly used to treat ocular and systemic conditions. Unmonitored use of steroids especially in eye drop formulations is common in situations when it is easily available over-the-counter, resulting in undesirable side effects. Among the ocular side effects, cataract and glaucoma are common.

Chronic administration of steroids in any form with raised IOP can cause optic neuropathy resulting in steroid-induced glaucoma1,2,3.

Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist 4,5.

Corticosteroid-induced IOP rise has been shown to occur with various methods of steroid administration, but is most identified as a complication of topical corticosteroid

application with drugs such as dexamethasone or prednisolone. In responsive patients, the IOP typically rises after several weeks of continual corticosteroid therapy and returns to normal following cessation of such therapy 6.

Corticosteroid glaucoma often occurs in children undergoing treatment for vernal keratoconjunctivitis 7.

Corticosteroid-induced glaucoma is a well- recognized phenomenon in adults, but not in children. We describe an infant who developed juvenile glaucoma with buphthalmos while receiving topical steroid treatment. The intraocular pressure normalized several months following discontinuation of treatment.