1992 Volume 15 Issue 2 Pages 148-153
From the beginning of 1981 to the end of 1990, 125 patients with connective tissue diseases have continuously received more than 20mg/day of prednisolone. The correlations between the increase in the ocular pressure and ocular symptoms due to corticosteroid administration were studied. We found 15 episodes of visual disturbance from 12 patients of our own and 2 patients transferred to our clinic, including 13 episodes in 12 patients with systemic lupus erythematosus. The clinical symptom most specific to glaucoma was blurred vision that was complained as “I feel as if I were in mist”. Disturbance in visual acuity was the next, but this symptom was not specific for glaucoma although observed frequently. Ocular pain and nausea were observed after prolonged increase in the ocular pressure, suggesting that these signs should be thought as more serious ocular symptoms. Increase in the ocular pressure appeared within 2 months after the initiation of the corticosteroid administration in 11 episodes and in the other 4 were observed later than 100 days when the patients were in remission. Response to acetazolamide (Diamox) or ophthalmic preparations was fair in 10 episodes, but 5 patients needed decompression operation. We conclude that the increase in the ocular pressure due to corticosteroid is not specific for SLE, and the serious eye damage can be avoided by careful monitoring of the ocular pressure and education of the patients with connective tissue diseases receiving corticosteroid about the risk of ocular damage.
