It has been half a century since glucocorticoids were first prescribed. Now we call them corticosteroids, or simply steroids, or just ‘roids’ (for fans of Major League Baseball!)
Steroids are chemicals similar to hormones produced by the adrenal glands atop the kidneys. These powerful drugs are a double-edged sword because they quickly relieve inflammation but at the same time can cause complications elsewhere in the body. Chronic steroid use can lead to weight gain, diabetes, high blood pressure, fragile bones, poor tissue healing, mental confusion, and increased susceptibility to infection. Doctors know about these problems and try to manage the patients’ health problems with the minimal steroid dose over the shortest possible time.
Steroids can be administered in pill form, intravenously, injectable (preferred by athletes), as well as though oral/nasal inhalers and eyedrops.
We know that one-in-ten people who take long-term steroids such as Prednisone can experience a rise in their intraocular pressure (IOP). We call these folks STEROID RESPONDERS. Serial IOP measurements are required in order to confirm that diagnosis.
Now, what if an existing glaucoma patient is also a steroid responder? There can be a dangerous IOP rise. This can lead to irreversible damage to the optic nerve…the ‘TV cable’ which connects the eye with the brain.
Beware of that sword! Anyone receiving any kind long-term steroid therapy needs regular eye exams and pressure checks. This applies not only to ophthalmology patients with inflammatory eye disorders like uveitis, but also to asthmatics, allergy sufferers, and folks with chronic conditions like lupus, fibromyalgia, and sarcoid.