Steroids are a group of anti-inflammatory drugs, commonly used to treat ocular and systemic conditions. Unmonitored use of steroids especially in eye drop formulations is common in situations when it is easily available over-the-counter, resulting in undesirable side effects.Among the ocular side effects, cataract and glaucoma are common. Steroid-induced ocular hypertension was reported in 1950, when long-term use of systemic steroid was shown to increase the intraocular pressure (IOP). Chronic administration of steroids in any form with raised IOP can cause optic neuropathy resulting in steroid-induced glaucoma.This review describes the pathophysiology and epidemiology of steroid-induced glaucoma, recognition of side effects, and principles of management. The purpose is to familiarize all clinicians with the potential dangers of administering steroids without monitoring the eye and the dangers of irreversible blindness in some instances of habitual self-prescription by patients.
Aim To assess the demography, magnitude, and type of corneal astigmatism in patients undergoing cataract surgery in North India. Methods It is a clinic-based, cross-sectional, observational study. Keratometric values and demographic data were collected for eligible patients who had undergone phacoemulsification at a tertiary eye care center between January 2010 and December 2017, using a non contact, optical low coherence reflectometry (OLCR). Results A total of 3597 eyes were recruited for the study. There were 1810 (50.3%) females and 1787 (49.7%) males. The mean age was 59.121±15.19 (range 5–100 years). A total of 3559 eyes were qualified for astigmatism analysis. The mean corneal astigmatism among all patients was 1.17±1.15 D (range 0–12.5 D). There was no astigmatism in 99 eyes (2.78%), with-the-rule (WTR) in 1062 eyes (29.83%), against-the-rule (ATR) in 1843 eyes (51.72%) and oblique astigmatism (OA) in 555 eyes (15.59%). The tendency of a gradual change from with the rule (WTR) to against the rule (ATR) astigmatism was noted as the age advanced. Conclusion In the present study around 56.69% of eyes had corneal astigmatism of <1.0 D that can be managed by simple cost-effective keratorefractive procedures especially in developing countries. However, our 40.49% patients had >1.0 D of corneal astigmatism, which may benefit by toric intraocular lenses.
Undifferentiated pleomorphic sarcoma (UPS), earlier known as malignant fibrous histiocytoma, is a rare entity in the orbit. Here, we report a case of UPS in a 34-year male, who presented as rapidly progressive unilateral proptosis with no history of any other systemic diseases. The tumor was removed surgically, followed by adjuvant chemotherapy and radiotherapy. After one year follow-up, the patient had not shown any orbital recurrence but had lung and gastrointestinal metastasis. UPS is rare, but because of its aggressive behavior, it should be included in the differential diagnosis of orbital tumors.
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