steroid

[re8]

Long term use of steroid for arthritis predispose to ?glaucoma vs. cataract

Both could happen but which one is more common?

Thanks

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[Visionary]

Cataract development is much more likely than glaucoma with prolonged systemic corticosteroid treatment, though the latter is a possibility. I've only seen glaucoma from systemic treatment once, but I've seen cataracts numerous times. Now, with long-term topical/intravitreal corticosteroids, glaucoma (or at least ocular hypertension) risk is around 20%, whereas, some degree of cataract development is practically inevitable.

 

[OMD]

Agree that cataract progression is more common but systemic, inhaled, and nasal spray steroids can often cause increased pressure. Just finished seeing a patient who came with IOP 28 without glaucomatous damage, but off nasonex, IOP 18. It's definitely less common than cataract progression but it definitely needs to be considered and inquired about before reflexively starting IOP gtt, like I have done in the past I'm sure.