Welcome to the message board forum for Krukenbergs Spindle and Pigment Dispersion Syndrome.
Here you will be able to post messages or reply to messages posted by other people... share your experiences of PDS or Krukenbergs.
Tracy's Message Board Forum
Welcome to the message board forum for Krukenbergs Spindle and Pigment Dispersion Syndrome. Here you will be able to post messages or reply to messages posted by other people... share your experiences of PDS or Krukenbergs. |
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| Viewing Page 1 of 1 (Total Posts: 7) |
| Author | Comment |
Tracy
 IP: 84.68.9.178 Jul 3, 07 - 5:38 PM |
Steroids and risk of higher IOPs
Today I was told that I'll have to have an operation on my hand, but if they decide not to operate, they'll give me a steroid injection to ease the pain and allow some mobility back. The effect of the injection apparently wears off after a month or so, so would have to be repeated quite frequently. Would the steroid injections increase my IOP's, especially if administered over a period of time? Should I just go for the operation and cut out the injections entirely? It would mean having my hand in a cast for a few weeks. |
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Dave
IP: 193.62.251.16 Jul 4th, 2007 - 11:47 AM |
Re: Steroids and risk of higher IOPs
Hi Tracey, Just a quick question before I begin, is this thought sparked by something the injection people mentioned? Or from your own knowledge of steroid/IOP interactions? It's just that when we worry about steroid increasing IOP, it's normally systemic (i.e. Tablets or intra-venous injections) not topical application (creams, sprays etc). A sub set of the normal population have a transient rise in IOP when using steroid drops (most commonly found after cataract surgery) but it's only about 20%. I guess I'm wondering if the injection will have much systemic absorption (if any) to make us worry about your IOP. Steroids have a bunch of other side effects when taken systemically, some of them quite unpleasant. These require careful monitoring (steroids are the greatest double edged sword of medicine). If these haven't been mentioned to you, then odds are good there will be too little systemic absorption to trouble you. Hope this helps. Dave |
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Tracy
IP: 84.71.104.175 Jul 4th, 2007 - 2:30 PM |
Re: Steroids and risk of higher IOPs
Hi Dave, I remembered reading that secondary glaucoma can be caused through prolonged use of steroids. The consultant at the hospital wasn't able to help, and told me that I'd have to ask when I came in for the injections. My worry was that although the effects of the steroids wear off after a time, could they cause more damage to my eyes when first injected, when they're at their strongest, so to speak. I've just done a quick check on yahoo and come up with these links: http://www.glaucoma.org/learn/cataracts_and_g.html http://www.glaucoma.org/news/glaucoma_resear_2.html http://www.wills-glaucoma.org/supportgroup/20021113.php http://www.glaucoma.org.au/whatis.htm http://www.eyemdlink.com/Condition.asp?ConditionID=419 but I'm still unsure what to do. Currently, I think I'll more than likely have the operation and get it over and done with, once and for all! Tracy |
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Dave
IP: 193.62.251.16 Jul 4th, 2007 - 4:58 PM |
Re: Steroids and risk of higher IOPs
I don't think I've made myself clear. IOP can be raised by steroids in two ways. 1. Topical application by eye drops. This tends to be a short term problem as very few people are left on this treatment for long periods of time. 2. Systemic steroid use (tablets, intra-venous injections etc) which is either high dose or long-term. I'm questioning whether this series of injections is either (well, I know it's not the first one) as the injections sound to be aimed at local anti-inflammatory effect (so very little systemic absorption) as opposed to systemic effect. If it was the latter, pills managed by your GP would be much cheaper, more convenient etc. Sounds like the location is all important, which again points towards localised use. Which consultant did you speak to? Your ophthalmologist or hand surgeon? |
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Tracy
IP: 84.68.64.99 Jul 4th, 2007 - 10:35 PM |
Re: Steroids and risk of higher IOPs
Thanks for your quick reply, Dave. I spoke to the hand surgeon (although not the doctor that would do the operation, it was one of the doctors doing his surgery while he sat in an office). The GP that referred me in the first place told me to ask, but as I've said, the doctor at the hospital didn't know whether it would affect the IOP's or not (he seemed rather keen to tell me not to eat cheese scones, as they tasted awful)  If I've understood you correctly, the injection probably wouldn't be strong enough to affect my IOP's, as it would be localised to my hand, and therefore not systemic? Having the steroid injections would allow more use in my hand, but the problem would still be there. When the anti-inflammatory effect of the steroids wore off, I'd be back to square one, and would then need further injections. On a physical and convenience level, the injections would be ideal, as looking after the baby would be a lot more difficult with one hand in a cast for several weeks, but if there IS a risk of damaging my eyes, I'd rather have the operation and get it over and done with. |
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Dave
IP: 193.62.251.16 Jul 5th, 2007 - 11:08 AM |
Re: Steroids and risk of higher IOPs
If there was any risk of systemic steroid absorbtion, your GP should be told of it. They are the front line in watching and managing for steroid side effects, better placed and more experienced with it than many other specialties. If he hasn't, then chances are it isn't going to. When you next see the hand surgeon, my advice would be not to mention IOPs in isolation but talk about systemic steroid absorption. This takes him/her away from something they don't know about IOP and steroid responders, to something they should know: the side effects of treatment they are offering. Hope you can get the info you need to make your choice. Dave |
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Tracy
IP: 62.136.11.175 Jul 5th, 2007 - 11:35 AM |
Re: Steroids and risk of higher IOPs
Thanks, Dave, I'll do that. |
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