A Case of Steroid-Induced Glaucoma Caused by a Sub-Tenon's Capsule Injection of Triamcinolone Acetonide

Background: We report a case in which steroid-induced glaucoma was caused by a sub-Tenon's capsule injection of triamcinolone acetonide and surgery was required to reduce intraocular pressure (IOP). Case Report: A 53-year-old female had been treated at another clinic with steroid eye drops for continuous bilateral uveitis. For cystoid macular edema (CME) we prescribed 32 mg triamcinolone acetonide by bilateral sub-Tenon's capsule injection. Twenty days after injection, CME was decreased in both eyes but IOP was increased in both eyes (right eye, 26mmHg; left eye, 37mmHg). Because IOP continued to rise and visual field defects developed despite administration of anti-glaucoma medications, we performed trabeculectomy in both eyes. After surgery, IOP stabilized at about 10 mmHg. Conclusion: When ophthalmologists use steroid medications, we must consider not only the effect on the disease being treated but also the influence on IOP, which depends on the specific steroid drug used and the route of administration.