OBJECTIVE: To determine the frequency of glaucoma in children with vernal conjunctivitis using
topical steroids, referred to a tertiary eye care centre.
DESIGN: Descriptive case series.
SETTING: This study was carried out at department of Ophthalmology, Liaquat University Eye
Hospital Hyderabad, Sindh - Pakistan, from July 2002 to December 2004 (Thirty months).
PATIENTS AND METHODS: A total of 200 patients with chronic allergic conjunctivitis using topical
steroids (Betamethasone, Dexamethasone, Prednisolone) for more than six months were
examined. A thorough examination including visual acuity, Goldmann applanation tonometry,
Schiotíz tonometry, Gonioscopy, slit lamp examination and dilated Ophthalmoscopy were performed.
RESULTS: Out of 200 patients examined, fifteen (7.5%) were found having raised intraocular
pressure (secondary glaucoma) due to prolonged use of topical steroids. The rise of intraocular
pressure was bilateral in three patients (1.5%), and unilateral in twelve patients (6.0%). The topical
steroids were discontinued. One patient with vernal conjunctivitis using topical steroids
since more than two years developed left optic disc pallor with constriction of visual field, and
posterior sub capsular cataract. The intraocular pressure was not controlled by ocular hypotensive
agents, and glaucoma filtration surgery was advised.
CONCLUSION: This study identifies the risk of intraocular pressure elevation in patients with
allergic conjunctivitis, using topical steroids for longer periods. Long term use of topical and
systemic steroids produces secondary open angle glaucoma similar to chronic simple glaucoma.
We can conclude that Dexamethasone and Prednisolone are possible risk factors for producing
Vernal conjunctivitis. Corticosteroids. Glaucoma.