Glaucomatous Damage Secondary to Long Term Topical Corticosteroid Use in a 7-Year-Old Female ()
Abstract
Introduction: Topical
corticosteroids are commonly prescribed for children with atopic dermatitis.
Although generally well tolerated, long term unsupervised use can lead to
ocular damage, including glaucoma. Much of the current literature focuses on
the periorbital use in older patients. We present a case of an adolescent who
suffered glaucomatous damage secondary to long term topical steroid use on her
extremities. Methods: This is a case report of a child with extensive work-up
for glaucoma suspect. Results: A 7-year-old African American female was found
to have glaucomatous damage after using 2.5% hydrocortisone cream on her arms,
legs, and back of neck twice daily continuously for 2 years. There were no
other mechanisms that could have produced a secondary glaucoma. Congenital
anomalous disk is a remote possibility. Discussion: Steroid cream use for
atopic dermatitis is relatively common. The side effect profile of topical
corticosteroids has been well documented and includes glaucoma. These patients
may not have any visual symptoms, and can present at an advanced stage, with
irreversible vision loss. Children with atopic dermatitis are especially
susceptible to the systemic effects of steroids because of the damaged
epithelial layer and also the body surface area to volume, both of which
increase the bioavailability of the medication. Conclusion: Because topical
steroids are commonly used, especially in children, patients need to be aware
of the potentially dangerous side effects, including vision loss from glaucoma.
Share and Cite:
Greenwood, M. and Grigorian, F. (2014) Glaucomatous Damage Secondary to Long Term Topical Corticosteroid Use in a 7-Year-Old Female.
Open Journal of Pediatrics,
4, 62-66. doi:
10.4236/ojped.2014.41008.
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
|
Rhee, D. J., Roy, H. and Gedde, S. (2012) Drug-Induced Glaucoma. Medscape.
|
[2]
|
Cubey, R.B. (1976) Glaucoma Following Application of Corticosteroid to the Skin of the Eyelids. British Journal of Dermatology, 95, 207-208. http://dx.doi.org/10.1111/j.1365-2133.1976.tb00830.x
|
[3]
|
Zugerman, C., Sauders, D. and Levit, F. (1976) Glaucoma from Topically Applied Steroids. Archives of Dermatology, 112, 1326. http://dx.doi.org/10.1001/archderm.1976.01630330080032
|
[4]
|
Neilsen, N.V. (1978) Sorenson PN. Glaucoma Induced by Application of Corticosteroids to the Periorbital Region. Archives of Dermatology, 114, 953-954. http://dx.doi.org/10.1001/archderm.1978. 01640180085023
|
[5]
|
Sahni, D. (2004) Glaucoma Induced by Periorbital Topical Steroid Use—A Rare Complication. Clinical and Experimental Dermatology, 29, 617-619. http://dx.doi.org/10.1111/j.1365-2230.2004.01610.x
|
[6]
|
Hengge, U.R., Ruzicka, T., Schwartz, R.A. and Cork, M.J. (2006) Adverse Effects of Topical Glucocorticosteroids. Journal of the American Academy of Dermatology, 54, 16-18. http://dx.doi.org/10.1016/j.jaad.2005.01.010
|
[7]
|
Haeck, I.M., Rouwen, T.J., Timmer-de Mik, L., de Bruin-Weller, M.S. and Bruijnzeel-Koomen, C.A. (2011) Topical Corticosteroids in Atopic Dermatitis and the Risk of Glaucoma and Cataracts. Journal of the American Academy of Dermatology, 64, 275-281. http://dx.doi.org/10.1016/j.jaad.2010.01.035
|