Corticosteroids and the eye

There’s generally no reason why someone shouldn’t be able to use a steroid inhaler or steroid spray. However, these should be used with caution in people with ongoing infections, like tuberculosis (TB). Corticosteroids can also be used to replace certain hormones that aren’t naturally produced by the body.

Inadvertent use of topical steroids in the latter condition can lead to the extension of the ulcer and marked visual deterioration. Corticosteroids can weaken your immune system and make you more vulnerable to infection. This means you should avoid any live vaccine until at least 3 months after your course of corticosteroids has finished. There’s some evidence that steroid inhalers used by people with chronic obstructive pulmonary disease (COPD) can increase the risk of chest infections like pneumonia. Discuss this with your health professional if you’re concerned.

Occasionally, eye pressure may need to be lowered using Diamox pills. Regardless of potency, children’s pupils tend to dilate wider and for a longer period of time compared to most adults. Wearing sunglasses, especially those with Polaroid lenses, will help with problems of glare and photosensitivity.

Two common side effects of Ozurdex include;

As with any medical or surgical procedure there is a small risk of complications following intravitreal injections. For most patients the benefit of the treatment outweighs the risks. Injections are performed as an outpatient procedure, either in the Eye Clinics procedure room or Treatment Centre.

A leaflet for patients who are taking long term steroid treatment. A child taking steroids is at an increased risk of infection. If they have a fever, or become unwell, contact your doctor or nurse. Steroids affect your child’s immune system, so they shouldn’t have any ‘live’ vaccines if they’re receiving a high dose of injected or oral steroids. But it’s important they’re up to date with other vaccines beforehand to avoid catching one of the diseases that vaccination prevents.

Irritation to stomach lining

It’s very common for multiple sclerosis to cause eye problems, and many people with MS have problems with their vision at one time or another. There are a number of glaucoma drops, and the treating doctor will ask questions about general health before selecting the best drop for the patient. Glaucoma drops can cause side effects and if the doctor is told about these, it’s often possible to change the drop. When there is a lot of inflammation, the drops are used every two hours to begin with, sometimes even more frequently. As the inflammation subsides, the drops are reduced (tapered) to six a day, then four a day, then three, two and one.

Any discomfort experienced will depend on various factors as some individuals may be more sensitive than others. The speculum used to keep the eye open may cause a pressure sensation and discomfort in some patients. Optic neuritis symptoms can include blurry vision, ‘washed out’ colour vision, and eye pain for a few days when you move your eyes. The long-term use of steroid eye drops will cause cataracts and may cause glaucoma. Having enough calcium and vitamin D is important, as steroids can increase calcium loss by the kidneys. Systemic corticosteroids and levofloxacin are excreted into human milk.

What dose will I take?

Usually, this is short-term and the balance is restored once you stop taking steroids. While your blood sugar levels are disrupted, avoid sugary foods and drinks. Some types of uveitis cause a rise in ocular pressure, for example inflammation caused by the herpes virus (the one that gives you a cold sore). It is also common for steroid eye drops to cause a rise in pressure. This is why our pressures are checked at every clinic visit.

Adrenal crisis

Immunosuppressants can also affect the functioning of some organs and systems, such as the lungs, liver, kidneys and bone marrow. Blood tests are needed at regular intervals to check these systems remain healthy. However, mydriatic eyedrops can cause some temporary blurring of your vision and problems focusing your eyes. How long you’ll have to take oral steroids for depends on how well you respond to treatment and whether you have an underlying autoimmune condition.

Symptoms of uveitis

To minimise any side effects, you’ll be prescribed the lowest possible dose to control your symptoms. You may have temporary blurred vision after using the drops. Don’t drive or operate machinery until your vision returns to normal.

Patient InformationIntravitreal Steroid (Triamcinolone) Injection

Safety for use in pregnancy and lactation has not been established. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate and intrauterine growth retardation. There may be a very small risk of such effects in the human foetus. In the ear, topical corticosteroids are contraindicated in patients with fungal diseases of the auricular structure, and in those with a perforated tympanic membrane. Bacterial, viral, fungal tuberculous or purulent conditions of the eye. Use is contraindicated if glaucoma is present or where herpetic keratitis (e.g. dendritic ulcer) is considered a possibility.

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