Eyes and long term prednisone

[renep73]

I have been on prednisone consistently for 8 months and sporadically for about 10 months before that (dx w/ systemic vasculitis).  Lately, I feel an increase in pressure behind my eyes - mostly on right side.  (I've had no issues with my eyes before this.)  I also have chronic sinusitis and pressure in the ears.  I know long term prednisone can cause glaucoma, but how long is a long time?  Could the pressure I'm feeling be the start of glaucoma, or could it just be a result of the inflammation issues I seem to have surrounding the eye?  I also occasionally feel like my right eye is blurry/cloudy ... a few blinks later and it seems fine.  Because of the inconsistency I haven't worried much about it, but with the increase in pressure, I'm beginning to wonder if something is brewing.  I have a yearly follow-up with my Opthamologist in a few weeks.  What type of testing should I discuss with my doctor?
Thank you.

[John C Hagan III, MD, FACS]

You should start by reviewing with your Eye MD the above history. Normally my patients going on long term steroids I see every six months. If your pressure is high or you have other risk factors a baseline glaucoma evaluation might be done: visual field, optic nerve photos, gonioscopy, central corneal thickness measurements and optic nerve OCT.

Steroid glaucoma can develop in as little as 2 weeks but that usually steroid eye drops. for oral medication I suspect 3-4 weeks would be average. Also systemic vasculitis can get in the eye.

JCH IIIMD