The subject of steroids as a cause of glaucoma probably deserves its own
thread, rather than just building onto the one on general "Causes of glaucoma."

There was an interesting comment by Dr. Elliot Werner of Wills Glaucoma
Service, Philadelphia, on the Glaucoma Chat of August 27, 2003. "The normally
produced steroid hormones do not seem to harm the eyes.  But ONE THEORY OF
GLAUCOMA is that it is an abnormal response to natural steroids produced in the
body, due to an ABNORMAL SENSITIVITY OF THE EYE TO STEROIDS."  (Emphasis
added.)

Looking into this further, I found evidently a relatively small percentage of
people have this sensitivity, but they tend to be people who have glaucoma.
And, nearly half of glaucoma patients, according to one report, react to
steroids with increased eye pressure. Another intreresting aspect is that the
reaction often depends on the number of exposures to steroids. The usual
assumption seems to be that it takes high doses of steroids over an extended
period to result in increased pressure. That may be true in the initial event,
however, once exposed, some sources suggest that the next exposure may require
a smaller dose and may raise pressure almost immediately. This would appear to
be similar to development of  most any allergy, such as bee stings, when the
first exposure sensitizes the individual, and the next exposure results in a
dramatic response (i.e. anaphylactic shock, which can be fatal).

Many steroids appear to have the capability of causing increases in IOP. Among
those I ran into very quickly were the common hydrocortisone (used in many
preparations--skin creams, drops, oral products, sprays), prednisone of course,
rimexolone, loteprednole, prednisolone. Since the body produces its own
steroids, it would not even be necessary to consume a medication to encounter
steroid induced pressure increases.

I did a Yahoo search using the terms "glaucoma" and "steroids" and found 55,500
references. There were 28,000 references to "glaucoma" and the brand name of
one popular nasal spray. Anyone wanting more detailed information might want to
do similar searches.

Finally, it might be helpful to consider why steroids might have this influence
on pressure. The answer may be rather simple--steroids are produced by the
adrenal system, which controls fluid balances, largely by regulating the
relationship of sodium to potassium.

FYI my involvement in this newsgroup is only as a patient with an interest in
the subject of glaucoma.