1e:T483,

Introduction

The finding of γ-globulin and plasma cells in the trabecular meshwork of glaucomatous eyes suggested an immunogenic component.^1,2The present study was undertaken to determine, under controlled conditions, the effect of topical corticosteroids in the eye with primary open-angle glaucoma. Corticosteroids have been incriminated in the exacerbation or production of the glaucomatous state.^3-7Such reports were largely concerned with glaucoma occurring during the course of uveitis and were difficult to interpret. Several authors have demonstrated no effect of steroids on intraocular pressure.^8,9,10In a controlled study of topical steroids in nurses, Linnér¹¹noted a small but significant increase in intraocular pressure without change in outflow facility. François¹²and Goldmann¹³have recorded glaucomatous states after prolonged topical steroid therapy, but these were considered rare occurrences. Recently Bernstein and Schwartz¹⁴found that patients on long-term systemic corticosteroid therapy showed significantly higher mean applanation pressures1f:T4e2,Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal20:T43d,

Introduction

With the increasing use of long-term systemic steroid therapy, reports on its possible ocular effects have been sporadically appearing in the literature. Recently cataract formation has been noted.¹However, the majority of these reports have concerned themselves with the relationship of steroids to intraocular pressure. There is suggestive evidence that steroids may play a role in the normal physiological control of intraocular pressure. Hill et al.²showed that the normal production of endogenous steroids follows a diurnal curve, similar to the ocular tension diurnal curve in the majority of individuals.^3,4Because of these parallel diurnal fluctuations, Linnér⁵investigated their possible relationship by measuring intraocular pressure and aqueous flow in a small group of patients without endogenous steroid production because of hypophysectomy or adrenalectomy. These patients were receiving exogenous steroids and presumably had a relatively constant level of steroids throughout the day and night. He found

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