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Steroid-induced glaucoma: an avoidable cause of irreversible blindness
  1. Benjamin H K Teo1,
  2. Jonathan T W Au Eong2 and
  3. Kah Guan Au Eong2,3,4
  1. 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  2. 2Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  3. 3International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
  4. 4Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
  1. Correspondence to Dr Kah Guan Au Eong; aueongkahguan{at}gmail.com

Abstract

A man in his 70s on regular follow-up with an ophthalmologist for 10 years presented with blurry vision in his right eye for 4 days. He was diagnosed with elevated intraocular pressure (IOP) bilaterally 18 months earlier and treated with antiglaucoma eye-drops. On direct questioning, he admitted to using fixed combination tobramycin 0.3%/dexamethasone 0.1% eye-drops frequently to relieve ocular redness and discomfort in both eyes for 3.5 years without his ophthalmologist’s knowledge. Examination disclosed markedly elevated IOP, advanced optic disc cupping and tunnel vision due to steroid-induced glaucoma bilaterally. After cessation of the eye-drops and 2 weeks of antiglaucoma therapy, his IOP returned to normal and his visual field remained stable for 4 years.

Our case highlights the danger of habitual self-treatment of prescription medications containing corticosteroids and the importance of taking a detailed medication history in the diagnosis and management of steroid-induced glaucoma.

  • Global Health
  • Glaucoma
  • Public health

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BHKT, JTWAE and K-GAE. The following authors gave final approval of the manuscript: BHKT, JTWAE and K-GAE.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.