Steroid-Induced Ocular Hypertension in Children: A Review on Risk Factors

Abstract

Purpose: Steroid-induced ocular hypertension is poorly understood in children, despite its frequent occurrence. Significant knowledge voids exist in steroid responsiveness, especially in the pediatric population. Therefore, highlighting the most critical risk factors in pediatric patients can help ophthalmologists identify who is at increased risk of developing a high steroid response. Methods: A manual search was conducted in PubMed and Google Scholar in search of relevant articles on the steroid-induced glaucoma subtopic. Results: Key risk factors for high steroid response include glaucoma family history, previous glaucoma diagnosis, young age, steroid type, administration route, and diseases such as vernal keratoconjunctivitis (VKC) and uveitis. Clinically, it presents similarly to primary glaucoma, except for steroid usage history. Steroid cessation or reduction can normalize intraocular pressure (IOP) levels; however, in some cases, pressure-lowering drugs are necessary for treatment. Conclusion: Topical ocular steroids are frequently used by pediatricians and ophthalmologists alike. Understanding the importance of risk factors allows for a timely diagnosis of steroid response and adequate treatment before glaucomatous vision loss can occur.

Keywords: pediatric glaucoma; steroid response; steroid-induced glaucoma; steroid-induced ocular hypertension.