Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids

Abstract

Purpose To investigate the observed high prevalence of spontaneous sub-conjunctival haemorrhage (SCH) in patients using long-term topical steroid treatment. Patients and methods A cross sectional survey of the occurrence of SCH was carried out in 248 patients using steroid eye drops and in a comparison group of 113 patients using topical glaucoma medication. Results Twenty-four patients with uveitis (10% of total) experienced single or recurrent SCH. Of these 71% used prednisolone acetate 1% (compared with 75% for those unaffected). None of 113 glaucoma patients were affected. Conclusions The long-term use of topical steroid for chronic uveitis substantially increases the prevalence of spontaneous or minimal-trauma SCH. Steroid-induced vascular fragility is the likely cause.

Reply to Mangat

“…Interestingly, he presented patients with presumed retrobulbar optic neuropathy based on the central scotomas and colour vision abnormalities experienced. 2 Our case report supports the suggestion that previously undetected optic neuropathy may be part of the DFO ocular toxicity spectrum.…”

“…[1][2][3] In 1984, Lakhanpal et al 2 reported retinal pigmentary degeneration and a presumed optic neuropathy with DFO. Interestingly, he presented patients with presumed retrobulbar optic neuropathy based on the central scotomas and colour vision abnormalities experienced.…”