Purpose To evaluate the intraocular pressure (IOP) after cessation of steroid use in steroid-induced glaucoma and its control with medication or surgery. Methods Thirty-four eyes of 34 patients having steroid-induced glaucoma were prospectively evaluated after cessation of steroid for IOP, visual acuity, and optic disc status at 3 months, and every 3 months for 18 months. Results Topical steroid use (73.5%) was the most frequent cause for glaucoma. The baseline IOP was 35.47712.59 mmHg. The baseline vertical cup-disc ratio correlated with duration of steroid use (P ¼ 0.014) and the baseline IOP (Po0.0001). In 25 patients (73.5%), IOP could be controlled by topical medications alone, whereas nine patients (26.5%) required surgery. The mean baseline IOP in eyes requiring surgery was 49.67713.28 mmHg and in eyes managed medically, 30.3677.51 mmHg (P ¼ 0.002). The vertical cup-disc ratio in surgically treated patient was 0.8770.13:1 as compared to 0.7170.15:1 (P ¼ 0.012) in the medically treated group. At 6, 12, and 18 months follow-up, 22 (64.7%), 33 (97.1%), and all 34 (100%) patients were off treatment, respectively. Conclusions Patients with steroid-induced glaucoma, who were r20 years old, with a higher IOP, and greater glaucomatous optic neuropathy, were more likely to need surgery. After cessation of steroid therapy, all eyes were off treatment at 18 months.

Purpose: To study the corneal topographic response to IOP reduction in vernal keratoconjunctivitis (VKC) with steroidinduced glaucoma. Methods: A total of 42 eyes of 21 patients with VKC and steroid-induced glaucoma (Group I) and 66 eyes of 33 patients with VKC without glaucoma (Group II) underwent an evaluation by Orbscan topography. In eyes with glaucoma, the IOP was controlled medically and the corneal topography was repeated at 3 months to evaluate effect on corneal parameters. Results: The mean baseline IOP was 36.40713.08 mmHg in Group I, 14.6774.62 mmHg in Group II (Po0.0001). The IOP after treatment at 3 months follow-up was 15.0075.41 mmHg in Group I (Po0.0001). In Group I, the mean maximum Sim K decreased from 44.8673.21 D to 43.8772.62 D (P ¼ 0.031) and mean posterior corneal elevation decreased from 64.9722.36 lm to 35.7728.91 lm at 3 months after reduction of IOP (P ¼ 0.001). There was a significant positive correlation between the reduction in the IOP and the decrease in the posterior corneal elevation (r ¼ 0.664, P ¼ 0.001). Conclusion: Eyes with VKC with and without glaucoma have similar corneal topography. Increased IOP associated with steroid-induced glaucoma and VKC may contribute to an increase in the corneal curvature and posterior corneal elevation. These changes may be reversed by a reduction in the IOP with medical therapy.