The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Steroid-related Ocular Hypertension and Glaucoma results from elevated intraocular pressure (IOP) due to the therapeutic use of glucocorticoids. Patients do not usually experience symptoms in the early stages and, if unidentified, the condition can lead to steroid-induced glaucoma and irreversible optic neuropathy. 75% of cases are due to topical steroid applications. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and managing steroid-related ocular hypertension and glaucoma. It provides recommendations for non-pharmacological management and pharmacological treatment, and outlines when urgent referral may be appropriate.
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What is steroid-related ocular hypertension and glaucoma?
Some steroid medicines, including eye drops, tablets, injections and implants, can increase the pressure inside the eye. 35% of the population are at risk of developing this problem. Raised eye pressure usually causes no symptoms, so most people do not realise it is happening. If high eye pressure is not treated, it can damage the optic nerve and lead to glaucoma. This can cause permanent loss of vision. Patients newly begun on steroid therapy should ideally have their eye pressures checked regularly.
How is steroid-related ocular hypertension and glaucoma managed?
When it’s safe to do so, stopping the steroid medicine usually allows the eye pressure to return to normal. If this does not happen, the condition may have to be treated as if it were an ordinary case of glaucoma (of the type known as ‘open angle’), using eye drops or possibly laser treatment or surgery.
Steroid-related ocular hypertension and glaucoma - 10 September 2026 The aetiology section has been updated to clarify the role of depot corticosteroid injections and different routes of administration in the risk of raised intraocular pressure. The predisposing factors section includes additional factors associated with an increased risk of developing steroid-related ocular hypertension and glaucoma. The non-pharmacological management section and management category section have been revised to more clearly outline the therapeutic changes that may be considered when a steroid response has been identified.
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