Prednisone is a corticosteroid medication prescribed for inflammatory and autoimmune conditions. While effective, it can cause side effects. Eyesight and vision concerns are common. This article explores how prednisone impacts vision, the eye conditions it may cause, and how eye health can be monitored and managed during therapy.
How Prednisone Impacts Vision
Prednisone can affect vision by influencing fluid and tissues within the eye. It can alter fluid dynamics, potentially increasing pressure. Risk of vision-related side effects generally increases with higher doses and longer treatment. Short-term use may cause temporary visual disturbances, but prolonged use is more commonly associated with serious issues.
Prednisone affects eye health by altering immune response and metabolic processes in eye tissues. It can affect the trabecular meshwork, the eye’s drainage system, leading to fluid outflow resistance and increased intraocular pressure. Some individuals are more sensitive, with risk factors including pre-existing glaucoma, a family history of glaucoma, diabetes, or extreme age.
Common Eye Conditions Caused by Prednisone
Prednisone use is linked to specific eye conditions, notably cataracts and glaucoma. It can cause posterior subcapsular cataracts, a cloudy area on the back surface of the eye’s lens. Symptoms include blurry vision, difficulty seeing in dim light, glare, and halos around lights. These cataracts are associated with prolonged glucocorticoid use; the exact mechanism is not fully understood, but it may involve effects on lens epithelial cells or ocular growth factors.
Steroid-induced glaucoma is another concern, occurring when prednisone increases intraocular pressure (IOP). This elevated pressure can damage the optic nerve, potentially leading to vision loss. It often presents similarly to other forms of open-angle glaucoma but is directly linked to corticosteroid exposure. Increased eye pressure can develop within weeks of starting prednisone, particularly with topical eye drops, though it can also occur with systemic use.
Central serous chorioretinopathy (CSCR) is also associated with corticosteroid use, including prednisone. In CSCR, fluid accumulates under the retina, resulting in blurred vision, distorted vision, or objects appearing smaller or farther away. Systemic corticosteroid therapy is a known trigger, but CSCR has also been reported with local administration of corticosteroids.
Monitoring and Managing Eye Health on Prednisone
Regular eye examinations are important for individuals taking prednisone, especially for extended periods or at higher doses. Inform the ophthalmologist about prednisone use for targeted monitoring of potential side effects like increased intraocular pressure and cataract development. Eye care professionals can conduct specific tests to detect early signs of these conditions, such as measuring eye pressure and examining the lens and retina.
Patients should be vigilant for any changes in their vision and report them promptly to their doctor. Symptoms that warrant attention include blurred vision, eye pain, redness, halos around lights, or any new visual disturbances. Open communication between the patient, the prescribing physician, and the eye care professional is important for managing risks and addressing any emerging issues. In some cases, if conditions like steroid-induced glaucoma are detected early, the intraocular pressure may return to normal after discontinuing the prednisone, though other interventions might be necessary.