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Systemic toxicity of topical corticosteroids.

Jitender Jinagal1, Parul Chawla Gupta1, Rakesh Kumar Pilania2

  • 1Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Indian Journal of Ophthalmology
|March 23, 2019
PubMed
Summary

Topical corticosteroids in infants, though rare, can cause systemic toxicity. Close monitoring and adjusted dosage are crucial to prevent serious ocular and systemic side effects in children.

Keywords:
Cushingoid habitusside effects of corticosteroidstopical corticosteroids

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Area of Science:

  • Ophthalmology
  • Pediatrics
  • Endocrinology

Background:

  • Corticosteroids are associated with ocular and systemic side effects via oral or parenteral routes.
  • Systemic toxicity from topical steroid eye drops is uncommon but possible.

Observation:

  • A 6-week-old infant with bilateral congenital cataracts developed increased intraocular pressure, weight gain, and cushingoid habitus.
  • These symptoms emerged 6-8 weeks after initiating frequent topical steroid eye drops post-surgery.

Findings:

  • The infant's side effects improved upon reducing the topical steroid dosage, indicating corticosteroid-induced systemic toxicity.
  • This case underscores the risk of systemic side effects from high-frequency, prolonged topical corticosteroid use in infants.

Implications:

  • Highlights the potential for serious systemic adverse effects from topical corticosteroids in infants.
  • Emphasizes the need for careful dosage adjustment and close monitoring of children using topical steroids.
  • Recommends maintaining topical steroid dosage within a therapeutic range to mitigate ocular and systemic risks.