Corticosteroids and Intraocular Pressure

Introduction  The finding of γ-globulin and plasma cells in the trabecular meshwork of glaucomatous eyes suggested an immunogenic component.^1,2 The present study was undertaken to determine, under controlled conditions, the effect of topical corticosteroids in the eye with primary open-angle glaucoma.Corticosteroids have been incriminated in the exacerbation or production of the glaucomatous state.^3-7 Such reports were largely concerned with glaucoma occurring during the course of uveitis and were difficult to interpret. Several authors have demonstrated no effect of steroids on intraocular pressure.^8,9,10 In a controlled study of topical steroids in nurses, Linnér¹¹ noted a small but significant increase in intraocular pressure without change in outflow facility. François¹² and Goldmann¹³ have recorded glaucomatous states after prolonged topical steroid therapy, but these were considered rare occurrences. Recently Bernstein and Schwartz¹⁴ found that patients on long-term systemic corticosteroid therapy showed significantly higher mean applanation pressures