Prolonged Steroid Use and Its Impact on Eye Health  

Many people use steroids for extended periods. Steroids can be administered as eye drops, nasal sprays, oral medications, or injections. Long-term use of steroids can elevate intraocular pressure (IOP), commonly known as eye pressure, above normal levels. This condition is referred to as **steroid-induced glaucoma**.  

Steroids can cause changes in the trabecular meshwork, leading to obstruction of aqueous humor outflow, which is termed **open-angle glaucoma**. However, not everyone experiences this issue. Some individuals have a sensitivity to steroids, known as **steroid responders**, who are more likely to develop this condition after prolonged or high-dose steroid use. In the early stages, the increase in eye pressure may be temporary and can normalize once steroid use is discontinued.  

Who Is at Risk?  

- Individuals with a family history of glaucoma.  

- Patients with Type-1 diabetes.  

- Those with myopia (nearsightedness).  

- Children under six years of age.  

- People with collagen diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis, or spondylitis.  

- Individuals using steroids directly in the eye.  

- Long-term users of inhalers or topical steroids.  

- Users of depot contraceptive steroids or intravitreal injections like triamcinolone.  

Precautions  

- Avoid using steroids if alternatives are available.  

- Do not use steroids without a doctor's prescription.  

- Individuals who use long-term steroid inhalers, depot contraceptive steroids, or those with collagen diseases, skin conditions, or eye problems should regularly monitor their eye pressure (IOP).  

- If elevated eye pressure is detected, discontinue steroid use immediately.  

Treatment 

If such problems occur, steroid use must be stopped. This may allow the eye pressure to return to normal naturally. If the pressure does not normalize, anti-glaucoma treatments similar to those for open-angle glaucoma may be required. In such cases, it is crucial to consult an ophthalmologist promptly.