Drug-related glaucoma
Corticosteroids are widely used in the eye, and the glaucoma they cause is also very common. Glaucoma caused by corticosteroids is open-angle glaucoma, which occurs after the use of corticosteroids in the eye or systemically, including eye drops or eye ointments, periocular injections, external application to the skin, systemic inhalation, oral or injection. After a long period of use, the increase in intraocular pressure is called corticosteroid glaucoma (corticosteroid glaucoma), also known as glucocorticoid induced glaucoma (GIG), or hormonal glaucoma for short. It was first reported by Francois in 1954. Its clinical manifestations and course are very similar to primary open-angle glaucoma. In addition to increased intraocular pressure, the fluidity of aqueous humor decreases, the angle of the chamber opens, and finally the glaucoma cup and visual field loss occur. It occurs more often in patients who use local eye medications than in those who use systemic medications, but patients with primary open-angle glaucoma are more sensitive to the increase in intraocular pressure caused by local use of corticosteroids. More than 50% of primary open-angle glaucoma patients experience an increase in intraocular pressure of more than 15 mmHg over baseline in the second week of corticosteroid instillation. Some patients even experience an increase in intraocular pressure within 3 to 5 days after frequent ocular instillation of hormones, such as 1% prednisolone acetate. The length of time corticosteroids are used or the height of intraocular pressure cannot predict how long it will take for intraocular pressure to drop. However, it should be noted that after several years of corticosteroid treatment, once corticosteroids are discontinued, intraocular pressure may not drop.