Lam C S, Umi Kalthum M N, Norshamsiah M D, Bastion Mlc
Department of Ophthalmology Universiti Kebangsaan Malaysia Kuala Lumpur, Malaysia.
Department of Ophthalmology Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur Malaysia.
Malays Fam Physician. 2018 Dec 31;13(3):32-37. eCollection 2018.
Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
类固醇性青光眼是不合理使用类固醇最严重的并发症,在患有过敏性结膜炎的儿童中尤为常见。这种情况依赖类固醇,全科医生通常会给儿童开局部抗炎药,包括局部用类固醇。此外,局部用类固醇在柜台也可买到,这导致在没有眼科医生适当监测的情况下过度使用。我们展示了一系列5个病例,说明儿童长期未经监测使用类固醇治疗春季角结膜炎的破坏性影响。这些药物最初由普通眼科医生开出处方,家长随后不断从柜台购买。在到我们中心就诊时,这些患者的视力已经受损,出现了青光眼性视盘改变和高眼压。该系列病例突出了长期局部使用类固醇导致儿童视神经损伤,造成不可逆的视力损害,以及定期监测并在低阈值时转诊至眼科医生的重要性。