Purpose

To evaluate the intraocular pressure (IOP) after cessation of steroid use in steroid-induced glaucoma and its control with medication or surgery.

Methods

Thirty-four eyes of 34 patients having steroid-induced glaucoma were prospectively evaluated after cessation of steroid for IOP, visual acuity, and optic disc status at 3 months, and every 3 months for 18 months.

Results

Topical steroid use (73.5%) was the most frequent cause for glaucoma. The baseline IOP was 35.47±12.59 mmHg. The baseline vertical cup–disc ratio correlated with duration of steroid use (P= 0.014) and the baseline IOP (P< 0.0001). In 25 patients (73.5%), IOP could be controlled by topical medications alone, whereas nine patients (26.5%) required surgery. The mean baseline IOP in eyes requiring surgery was 49.67±13.28 mmHg and in eyes managed medically, 30.36±7.51 mmHg (P= 0.002). The vertical cup–disc ratio in surgically treated patient was 0.87±0.13: 1 as compared to 0.71±0.15: 1 (P= 0.012) in the medically treated group. At 6, 12, and 18 months follow-up, 22 (64.7%), 33 (97.1%), and all 34 (100%) patients were off treatment, respectively.

Conclusions

Patients with steroid-induced glaucoma, who were≤ 20 years old, with a higher IOP, and greater glaucomatous optic neuropathy, were more likely to need surgery. After cessation of steroid therapy, all eyes were off treatment at 18 months.