Glaucoma is an eye disease characterized by high intraocular pressure. If pressure in the eye is too high this can lead to optic nerve damage which in turn can cause sight disturbances and even loss of vision. According to the American Academy of Ophthalmology, around three million Americans have glaucoma, but only half are aware they have the condition. There are a number of risk factors for glaucoma including certain disease such as diabetes and high blood pressure. Genetic factors may also play a role. There are certain medications that may increase the risk of glaucoma or exacerbate existing glaucoma.
Corticosteroids
According to the University of Maryland Medical Center (UMMC), corticosteroids may present a risk factor for two forms of glaucoma known as open-angle glaucoma and closed angle glaucoma. Corticosteroids can be delivered orally, topically or can be inhaled. According to UMMC, topical steroid treatments, especially those taken in the form of eye drops present the highest risk. UMMC advises that use of topical steroids be monitored carefully as they can cause permanent damage to the eye. High-dose oral corticosteroids can increase the risk of glaucoma but any eye disorders caused in this way are usually resolved a short time after stopping treatment.
Antidepressants
There have been several cases in the medical literature of glaucoma developing following treatment with certain antidepressants. A 2000 article published in the medical journal, "Ophthalmologica," describes a case of bilateral angle closure glaucoma and vision loss following treatment with the drug maprotiline for depression and clotiazepam and alprazolam for anxiety. The British National Formulary advises that the group of antidepressants known as tricyclic antidepressants which include the drugs imipramine and metapramine should be used with caution in patients who have a susceptibility to closed-angle glaucoma.
Anti-Seizure Drugs
Certain anti-seizure drugs used to treat epilepsy may exacerbate glaucoma. The drug topiramate, which is widely used due to its broad spectrum of therapeutic activity, has been linked to glaucoma. A 2006 article published in the "Journal of Postgraduate Medicine" highlights that there have been 86 cases of secondary angle closure glaucoma linked with topiramate. Patients taking topiramate who have a known susceptibility to glaucoma should be monitored very closely.
References
- American Academy of Ophthalmology: Glaucoma
- UMMC: Glaucoma - Causes
- Ophthalmologica: Bilateral Angle Closure Glaucoma and Visual Loss Precipitated by Antidepressant and Antianxiety Agents in a Patient with Depression
- British National Formulary: Tricyclic and related antidepressant drugs
- Journal of Postgraduate Medicine: Topiramate induced secondary angle closure glaucoma
