Steroid-induced glaucoma and blindness in vernal keratoconjunctivitis

Area of Science:

• Ophthalmology
• Glaucoma Research
• Allergic Eye Diseases

Background:

• Vernal keratoconjunctivitis (VKC) is a chronic allergic eye condition.
• Ocular hypertension and glaucoma are potential complications of topical steroid use in VKC.
• Steroid-induced glaucoma (SIG) can lead to irreversible vision loss.

Purpose of the Study:

• To investigate the clinical characteristics of patients with steroid-induced glaucoma (SIG) secondary to vernal keratoconjunctivitis (VKC).
• To determine the treatment outcomes and prevalence of blindness in VKC patients with SIG.

Main Methods:

• Retrospective review of VKC patients treated between 1992 and 2009 at a tertiary eye center.
• Diagnosis of SIG based on intraocular pressure (IOP) and/or glaucomatous optic disc damage.
• Definition of blindness as best corrected visual acuity ≤20/400 or visual field <10°.

Main Results:

• A prevalence of 2.24% for SIG was found in 4062 VKC subjects (91 patients, 157 eyes).
• SIG predominantly affected adolescent males, with a median age of 12 years at VKC onset.
• 31.8% of patients presented with bilateral blindness; 34% required glaucoma surgery.
• High presenting IOP and longer duration of steroid use were associated with the need for surgery.

Conclusions:

• SIG in VKC is a severe condition, primarily affecting adolescent males.
• A significant proportion of patients develop blindness and require surgical intervention.
• Early detection and management are crucial to prevent vision loss in VKC patients using steroids.