Q:

9/17/2012
At what age do you recommend glaucoma screening annually for patients on daily ICS?

A:

Thank you for your second inquiry, which was:

What age do you recommend glaucoma screening annually forpatients on daily ICS?

I have forwarded your question to Leonard Bielory who, as you know, is an internationally recognized expert on the ocular effects of corticosteroids. As soon as we receive his response, we will forward it to you.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

Below is the response from Dr. Leonard Bielory. Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Leonard Bielory:
Intranasal steroids are presently not a risk factor for induction increased intraocular pressure, but may do so in patients prone to it. The question of its prevalence in the general population is unknown and most agents have only been studied up to a year in clinical trials.

The question of increased may be worthwhile for those on chronic >2-3 years and who are in their 40''s that have risk factors.

The major risk factors for developing open-angle glaucoma include age (especially in individuals of Caucasian and African descent), black race (2-3 times higher; but also increased in Latinos), family history, and elevated intraocular pressure.

Age becomes an issue starting around age 55 with less than 1% prevalence and then increasing to 2% around age 65 and then 4% at 80.

Other facts about race is that in 2011, non-Hispanic white women comprise the largest group with open-angle glaucoma in the United States.

Family history may play the biggest role in assessment of screening or in patients with prior history of increased intraocular pressure.

Other possible risk factors for developing open-angle glaucoma include myopia, pseudoexfoliation, low diastolic perfusion pressure, cardiovascular disease, systemic hypertension, diabetes mellitus, and hypothyroidism.

Leonard Bielory

AAAAI - American Academy of Allergy Asthma & Immunology