Over-prescribing steroids to treat allergic conjunctivitis leads to SIG

New Delhi, India-Ophthalmologists are over-prescribing steroids to treat vernal keratoconjunctivitis (VKC) and causing an increase of steroid-induced glaucoma (SIG) in children, according to a recent study publish in the British Journal of Ophthalmology.

“We found many ophthalmologists prescribing steroids to children and not monitoring them for glaucoma,” said Viney Gupta, MD, MBBS, senior author of the study. “Many children develop a severe form of SIG and this goes undetected until they lose substantial vision.

Giant papillae in VKC (Photo courtesy of Viney Gupta, MD, MBBS)

“We believe what we see . . . may be just the tip of the iceberg,” continued Dr. Gupta, also an additional professor of ophthalmology, All India Institute of Medical Sciences, New Delhi.

The study followed 1,259 cases of pediatric glaucoma at All India Institute over a 5-year period. Fifty-nine (4.7%) children were diagnosed with SIG, and of these, 51 (87%) had been prescribed topical steroids for VKC.

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The median duration of steroid use was 18 months (range 1 month to 8 years).

Additionally, 82% of the children with VKC had been prescribed steroids by the treating ophthalmologist and 52% had been on topical steroids for less than 1 year.

Glaucoma was found to be the cause of blindness in 37.3% of the children, while low vision was found to be the culprit in 23.7%. Twenty seven percent were unilaterally blind at presentation.

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