Corticosteroid-Induced Ocular Hypertension

Abstract

Topical corticosteroids produce adverse effects, including an elevation in intraocular pressure. Initial observations suggested that the pressure response was genetically determined and that inheritance of this response was closely associated with that of primary open-angle glaucoma. The response would have been useful in screening the normal population or those at risk for glaucoma, and also for identifying those ocular hypertensives likely to progress to glaucoma, but this was never realized. Other workers were unable to demonstrate the trimodal frequency distribution that formed the basis of the concept of corticosteroid pressure response as a prognostic indicator and later evidence was produced to show that corticosteroid-induced ocular hypertension can be acquired. This pressure response therefore has no clinical role in glaucoma practice but its significance as an adverse reaction to prolonged use of topical corticosteroids is stressed. A hypothesis is postulated for the response's mechanism.