Open-angle glaucoma associated with topical administraion of flurandrenolide to the eye

Intraocular pressure was elevated in both eyes and a glaucomatous field defect developed in one eye of an 18-year-old Caucasian man after prolonged topical use of flurandrenolide. Spontaneous remission occurred in one eye, the eye with least drug exposure, within a few weeks. The other eye continued to show evidence of elevated intraocular pressure and further field loss developed over 4 years after discontinuation of the steroid. The most serverly affected eye became myopic. This case strongly suggests that chronic application of flurandrenolide into the conjuctival sac can produce corticosteroid-induced glaucoma in susceptible individuals. Although both eyes were normal before exposure to the steroid and elevations of the same level developed in both eyes at the peak of the disease, the eye with the least drug exposure underwent complete and spontaneous remission whereas the eye exposed more frequently appeared to show irreversible changes in the aqueous humor outflow pathway with subsequent loss of visual field.