title: Do reducing regimens of fluorometholone for paediatric ocular surface disease cause glaucoma?
abstract: OBJECTIVE
  Although fluorometholone (FML) is considered a steroid of minimal ocular penetration, reports in children have shown dose-dependent intraocular pressure (IOP) rise. The authors aimed to assess whether reducing regimens of FML for paediatric ocular surface disease have sustained clinically significant ocular hypertensive effects.
  
  
  METHODS
  Retrospective case-note review. Glaucoma was defined as an IOP of ≥ 21 mm Hg on at least two occasions or, in young children, moderate/firm digital IOP with one of the following: myopic shift, increased cup:disc ratio or corneal oedema. Exclusion criteria were other concurrent steroids or pre-existing optic nerve disease.
  
  
  RESULTS
  107 cases were included. The median age was 6 years (range 3 months to 17 years). The commonest indication for FML was blepharo-kerato-conjunctivitis. The maximal frequency prescribed was four times a day, gradually reduced to once weekly in cases of long-term treatment. The mean total number of eye-drop applications was 228 over a mean time span of 9 months. Post-FML IOP was formally documented in 51/107 casenotes (median age 6.85 years, range 4 months to 16 years) and it was <19 mm Hg in all cases. 56 cases did not allow IOP measurement (median age 5.9 years, range 3 months to 17 years), but none met the glaucoma definition.
  
  
  CONCLUSIONS
  In this cohort, reducing regimens of FML proved to be a safe anti-inflammatory treatment in terms of avoiding steroid-induced glaucoma.
authors.affiliation: Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital, London, UK.
authors.forename: Asimina
authors.initials: A
authors.lastname: Mataftsi
authors.forename: Aman
authors.initials: A
authors.lastname: Narang
authors.forename: Will
authors.initials: W
authors.lastname: Moore
authors.forename: Ken K
authors.initials: KK
authors.lastname: Nischal
mesh_terms: D000293:Adolescent; D001762:Blepharitis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005469:Fluorometholone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005901:Glaucoma / Q000139:chemically induced*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007637:Keratoconjunctivitis / Q000188:drug therapy; D008297:Male; D009883:Ophthalmic Solutions; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery
chemical_list: D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D005469:Fluorometholone