Prevalence of steroid-induced glaucoma among patients suffering from vernal kerato-conjunctivitis in central India

Abstract

The present study is aimed to assess the prevalence of steroid-induced glaucoma in vernal kerato-conjunctivitis patients treated with topical steroids and to determine the association between different types of topical steroids and the presence of steroid-induced glaucoma. This study was conducted as a hospital-based cross-sectional study on patients belonging to the age range of 8 years to18 years who were already diagnosed with vernal kerato-conjunctivitis and were using topical steroids as treatment. Detailed clinical history and ophthalmologic examination were done. Depending upon the potency of steroids and their intra-ocular pressure raising potential, patients were categorized into one of the 4 groups (A, B, C, D). Intra-ocular pressure levels were raised in 32.9% of the patients managed with topical corticosteroids. Steroid-induced glaucoma was observed in 15 (6.1%) of the patients with vernal kerato-conjunctivitis. Steroid-induced glaucoma was significantly associated with prolonged duration of corticosteroids and high potency corticosteroid use (p<0.05). Steroid-induced glaucoma is one of the common complications of injudicious and long-term use of topical corticosteroids particularly high potency steroids. Approximately one-third of the patients on treatment for vernal kerato-conjunctivitis are corticosteroid responders. High potency steroids and prolonged use of steroids are factors associated with steroid-induced glaucoma.

Reversal of Peripheral Anterior Synechiae After Trabeculectomy With Argon Laser Synechiolysis

“…Vernal keratoconjunctivitis (VKC) is a chronic disease that may require a prolonged duration of topical steroids to downregulate the disease activity in moderate severity [ 1 ]. Topical ophthalmic corticosteroids usually lead to a rise in intraocular pressure (IOP) after three to six weeks of continuous administration, although a rise may be observed within one week of initiating treatment.…”

“…Steroid use in VKC is often prolonged and may require high potency usage. This may lead to complications of secondary high intraocular pressure which may require surgical intervention in refractory cases [ 1 ]. Trabeculectomy is one of the options for glaucoma surgery where it creates an alternate route for aqueous outflow via an ostium.…”