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Steroid-induced glaucoma and childhood blindness
Shikha Gupta1, Pooja Shah1, Sartaj Grewal1
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
The British Journal of Ophthalmology
|May 24, 2015
Summary
Steroid-induced glaucoma (SIG) affects 4.7% of pediatric glaucoma cases, often leading to severe vision loss. Early detection and alternative treatments for conditions like vernal keratoconjunctivitis are crucial to prevent childhood blindness.
Area of Science:
- Ophthalmology
- Pediatric Glaucoma Research
- Public Health
Background:
- Steroid-induced glaucoma (SIG) is a significant cause of visual impairment in children.
- Topical steroid use, particularly for vernal keratoconjunctivitis (VKC), is a primary risk factor.
- Ophthalmologists must be aware of the potential for severe visual consequences.
Purpose of the Study:
- To determine the prevalence of SIG in pediatric glaucoma cases.
- To identify risk factors associated with SIG in children.
- To assess the severity of vision loss resulting from SIG.
Main Methods:
- Retrospective analysis of 5-year pediatric glaucoma case records.
- Evaluation of visual acuity, intraocular pressure, optic nerve damage, and visual fields.
- Parental interviews to ascertain steroid use details (indication, type, duration, prescriber).
Main Results:
- SIG accounted for 4.7% of pediatric glaucoma cases (59/1259).
- Topical steroids for VKC were implicated in 87% of SIG cases, with prolonged use (>1 year) common.
- 37.3% of affected children presented with blindness, and 23.7% with low vision due to glaucomatous optic neuropathy.
Conclusions:
- A significant proportion of children with SIG present with severe bilateral visual impairment.
- Ophthalmologists should consider steroid-sparing treatments for VKC.
- Close monitoring for glaucoma is essential in children using topical steroids.
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