Medication Side Effects Review: Steroids

Steroids (Corticosteroids)

Ever wonder why an optometrist wants you to list all of your medications?  Ever wonder what a medicine for arthritis, lupus, or any other condition has to do with a comprehensive eye health exam?

In this series of blog entries I’ll be talking about potential ocular side effects of  common medicines that are used to treat diseases throughout the body.  In fact, most common systemic medications have the potential to affect your eyes.    The incidence and degree of ocular side effects depends on the medicine, but letting the optometrist know your medications list will allow for special attention to  specific potential side effects during your  exam.

First up:  Steroids.    We’re not talking body-building,  Mark McGuire steroids.  Those are anabolic steroids.  We are talking corticosteroids.   This group of oral medications help control over-active responses from your immune system during a whole host of conditions.  Examples of conditions in which corticosteroids may be used include arthritis, lupus, dermatitis, severe allergies, Crohn’s disease, hepatitis, sarcoidosis, and many other conditions.   Two of the most common corticosteroids used are Prednisone and Dexamethosone.

Corticosteroids are one of the groups of oral medicines most likely to have ocular side effects.  Long term use of these medicines may lead to cataracts.    Steroid-induced cataract formation varies in its incidence and severity based on the individual and the dose and duration of the steroid use.   Eye exams, with pupil dilation, are indicated at regular intervals during long-term steroid use.  This way the optometrist can notify the primary care physician of this side effect.    If the cataracts become severe, cataract surgery may be indicated.

Another potential side effect of oral corticosteroids is an increase in eye pressure.  This increase in eye pressure has the potential to develop into glaucoma, which is an irreversible damage to the optic nerve resulting in permanent vision loss.   Again, regular examinations by the optometrist during the use of these medicines will allow for close monitoring of eye pressures. When pressure changes are caught early and treated with topical pressure lowering eye drops,  glaucoma may be prevented from occurring.

As always, if you have any questions, please feel free to email me at

Take Care,

Dr. Beach.