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Published on: December 4, 2007
Steroid-Induced Ocular Hypertension in Children: A Review on Risk Factors
Sebastian Lacau1, Alejandro Marin1, Elena Bitrian1
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Insights
Identifying risk factors for steroid-induced ocular hypertension in children is crucial. Early diagnosis and treatment of high steroid response can prevent glaucomatous vision loss.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Steroid-induced ocular hypertension is a significant concern in pediatric patients.
- Knowledge gaps exist regarding steroid responsiveness in children.
Purpose of the Study:
- To identify critical risk factors for high steroid response in pediatric patients.
- To aid ophthalmologists in identifying at-risk children.
Main Methods:
- A manual literature search was performed using PubMed and Google Scholar.
- Focused on articles related to steroid-induced glaucoma.
Main Results:
- Key risk factors include family history of glaucoma, prior glaucoma diagnosis, young age, steroid type/route, and conditions like vernal keratoconjunctivitis (VKC) and uveitis.
- Clinical presentation mimics primary glaucoma, with steroid use history as a differentiator.
- Intraocular pressure (IOP) may normalize with steroid cessation/reduction; some cases require medication.
Conclusions:
- Topical ocular steroids are widely used in pediatric care.
- Recognizing risk factors enables prompt diagnosis and treatment to prevent vision loss.
Abstract:
Purpose: Steroid-induced ocular hypertension is poorly understood in children, despite its frequent occurrence. Significant knowledge voids exist in steroid responsiveness, especially in the pediatric population. Therefore, highlighting the most critical risk factors in pediatric patients can help ophthalmologists identify who is at increased risk of developing a high steroid response. Methods: A manual search was conducted in PubMed and Google Scholar in search of relevant articles on the steroid-induced glaucoma subtopic. Results: Key risk factors for high steroid response include glaucoma family history, previous glaucoma diagnosis, young age, steroid type, administration route, and diseases such as vernal keratoconjunctivitis (VKC) and uveitis. Clinically, it presents similarly to primary glaucoma, except for steroid usage history. Steroid cessation or reduction can normalize intraocular pressure (IOP) levels; however, in some cases, pressure-lowering drugs are necessary for treatment. Conclusion: Topical ocular steroids are frequently used by pediatricians and ophthalmologists alike. Understanding the importance of risk factors allows for a timely diagnosis of steroid response and adequate treatment before glaucomatous vision loss can occur.
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