Risc factor use of corticosteroid with pre-existing glaucoma

[PaoloRossi]

Hi all,

I would like to know if there is a higher risc of increasing intra ocular pressure in a case of pre-existing glaucoma?

Thank you

[west98671]

No idea - I'm sorry.

[PaoloRossi]

Using= sueing

[PaoloRossi]

I am now using them, but according to my laywer problem is how to distuinguished between damage caused by vitrectomy and damage caused by high eye pressure. Given my history, I have had multiple examinations of the visual field, before and after, that show visual löss after surgery. I have had also Some examinations on the thichness of the optimale nerve ( don'tknow how it is called), but I don't have the actualiteit ' before' and 'after' results.

Any suggestie s how damage can be distuinguished ?

[PaoloRossi]

Problem is that they never told me about the possible effect of corticosteroid on eye pressure, so I couldn't advocate until it was to late...

[PaoloRossi]

Yes, currently I am using Xalacom and Azarga. But I have had others too,

[west98671]

I agree - given your condition, they should have checked your IOP early and often.  You need to be an advocate for yourself and insist that these tests are done, especially considering how simple the IOP test is...

Are you on medication for your glaucoma?

[PaoloRossi]

And sorry for the 'autocorrectins' misstaken. Using Ducth autocorrection when writing in English given Some unexspected results...:-)

[PaoloRossi]

I have had a retinal detachment, I was given a vitrectomy. I recognized the sympto s of the detachment in an early stage, because my father had seven...
Being diagnoses ten years ago with glaucoma I had severe damage in my Left eye, seeing about 20-25% so I have been using my right eye sincerely then. The detachment occurred in my right eye, surgery went OK, but they prescribed tobradex to aboud inflammation. I don't know if there was an alternatieve for this, but they only checked my eye pressure after 18 days, 36 mmHg. I can only imaginair what is has been before. They new about my condition of glauco au pront, they should never have raken the risk of using corticosteroids without frequently checking eye pressure.

[west98671]

I'm really sorry to hear about your eye problems.  Why did you have eye surgery?  Some more background information might help shed some light on why two doctors are insistent that that the steroids are safe for you...

[PaoloRossi]

Thanks so much.

After eye surgeon two years ago I was prescribed corticosteroids, they only checked eye pressure after eighteen days, shownieuws it was 36 mmHg. At day forteen, I saw the light disappearing in my eye to never come back completely. I know damage was caused by corticosteroids. I have 2 eye Md's in theNethetlands stating there is no increased risk when using corticosteroids in glaucomous eyes. Before surgery I had only one eye with clear vision, now I have none Left. I am fighting with them for two years now...

[west98671]

Corticosteroids have been shown to raise IOP.  If you have pre-existing glaucoma, the effect of the steroids would likely raise IOP regardless of that fact IMHO - in fact would raise it more BECAUSE of that fact.

Here is a pubmed link to a 1999 study that I found easily with google:

http://www.ncbi.nlm.nih.gov/pubmed/10641955

A quote from the abstract says, "Approximately 18 to 36% of the general population are corticosteroid responders. This response is increased to 46 to 92% in patients with primary open-angle glaucoma (POAG)."

This would tell me quite plainly that corticosteroids are not a good idea if you have glaucoma!!!  For the record, I would get another opinion before arguing with your doctor, but it doesn't seem like rocket science here...

[PaoloRossi]

Thank you.

Is there any scientific research I can relate to? I have a dispute with my eye MD on this. He insists that change is not higher in case of pre-existent glaucoma

[west98671]

In short, yes.  It depends on other factors as well - discuss with your eye MD.