Steroid induced glaucoma causes

If you have routine examinations and you develop glaucoma, the chances of serious vision loss from glaucoma are very remote. However, late detection or non-compliance may result in vision loss. One may think of glaucoma being analogous to a house on the beach. If a house is in good shape and is hit by a series of storms, then the house will survive the storms with little damage (high eye pressure with a healthy nerve). However, if the foundation of the house has been damaged by previous storms there is a significant chance that the house will either be further damaged or swept away by the storm (a damaged nerve can not take the excess pressure from glaucoma). Thus, the key to preserving vision is early detection with aggressive treatment. The chronic, progressive nature of the disease makes it difficult for the patient to faithfully take their medication - the key to preserving vision.

During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.

Some evidence from non-randomized small trials suggests that intravenous pulse steroid therapy twice a week may be associated with fewer side effects and may be more effective than oral steroid therapy for the treatment of Graves' eye disease. See High-dose intravenous corticosteroid therapy for Graves' ophthalmopathy. J Endocrinol Invest. 2001 Mar;24(3):152-8. and Graves' orbitopathy activation after radioactive iodine therapy with and without steroid prophylaxis J Clin Endocrinol Metab. 2009 Sep;94(9):3381-6 . Furthermore, weekly intravenous steroid therapy appeared to be associated with a better treatment outcome compared to daily therapy with oral steroid tablets, as described in Randomized, single blind trial of intravenous vs. oral steroid monotherap In Graves' orbitopathy. J Clin Endocrinol Metab. 2005 Jul 5; [Epub ahead of print] . In contrast, treatment with steroids does not seem to adversely impact the success of the treatment for hyperthyroidism Glucocorticoids do not influence the effect of radioiodine therapy in Graves' disease. Eur J Endocrinol. 2005 Jul;153(1):15-21.

Steroid induced glaucoma causes

steroid induced glaucoma causes


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