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Medical Forum / General / Vision / August 2006Ocular hypertension
Today my IOP levels were 23/30mm, exactly double those of six months ago. During that six month period, I have been using steroids as a treatment for CME. (So now I am supposed to refrain from doing this--there are also NSAIDS.) How likely do you suppose it is that the use of Pred Forte is indeed responsible for this instance of ocular hypertension? And is this level really dangerous? In a few weeks I'll let you know if you were right.  SignatureRobert T. Kopp http://analytic.tripod.com > Today my IOP levels were 23/30mm, exactly double those of six months ago. > During that six month period, I have been using steroids as a treatment for > CME. (So now I am supposed to refrain from doing this--there are also > NSAIDS.) Orally, or injected subtenon? > How likely do you suppose it is that the use of Pred Forte is indeed > responsible for this instance of ocular hypertension? And is this level > really dangerous? In a few weeks I'll let you know if you were right. But what other reason could there be? Is a doubling of the IOP dangerous? Time will tell. In the meantime, I assume that you are on glaucoma meds. DrG >> Today my IOP levels were 23/30mm, exactly double those of six months ago. >> During that six month period, I have been using steroids as a treatment >> for CME. (So now I am supposed to refrain from doing this--there are also >> NSAIDS.) > > Orally, or injected subtenon? Topically--drops. >> How likely do you suppose it is that the use of Pred Forte is indeed >> responsible for this instance of ocular hypertension? And is this level >> really dangerous? In a few weeks I'll let you know if you were right. > > But what other reason could there be? No other obvious reason: this is presumed to be the most likely. > Is a doubling of the IOP dangerous? Time will tell. In the meantime, > I assume that you are on glaucoma meds. It's something called levobunolol hydrochloride (also topical). SignatureRobert T. Kopp http://analytic.tripod.com > It's something called levobunolol hydrochloride (also topical). Your IOP's are 23/30 on levobunolol? DrG >> It's something called levobunolol hydrochloride (also topical). > > Your IOP's are 23/30 on levobunolol? No, that was before beginning such treatment--three days ago. The OD is now just a little outside the normal range, but the other one could use a little work. SignatureRobert T. Kopp http://analytic.tripod.com >Today my IOP levels were 23/30mm, exactly double those of six months >ago. During that six month period, I have been using steroids as a [quoted text clipped - 3 lines] >How likely do you suppose it is that the use of Pred Forte is indeed >responsible for this instance of ocular hypertension? Extremely likely. And if the intraocular tensions drop by half over time once you are taken off the steroids, there will be little doubt as to whether it was responsible. >And is this level really dangerous? First of all, there is no way to know a priori if this intraocular tension will cause glaucomatous optic neuropathy. However, a doubling of your intraocular tensions over 6 moths is a big red flag. Glacoma is a complex disease, and we as eye doctors are just scratching the surface in understanding it. The relative risk depends on a few things, such as your current optic nerve status, cardiovascular status, and life expectancy. |
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