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Most common side effects of systemic corticosteroids are posterior subcapsular cataract and glaucoma. There is no way to prevent corticosteroid-induced cataract. The risk of these complications varies (cataract 11 to 15%; glaucoma 12.8%), and it depends on the dose, duration of administration and terrain. The discontinuation of corticosteroid therapy is required in cases of uncontrolled glaucoma by hypotonic treatment. Long-term topical or general steroids prescription has to be done after an ophthalmological examination. Indications of ophthalmic general corticosteroids are acute orbital and ocular inflammations. affecting the middle and posterior segments of the eye, or sclera when topical treatment is ineffective. When administered topically, only 5% of the delivered dose is absorbed by the anterior segment, distribution is almost zero in the middle and posterior segments of the eye.
Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu, université Paris Descartes, service de médecine interne, 75004 Paris, France.
Full article9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)