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PMR and Glaucoma

Posted , 14 users are following.

bob73443
bob73443

Hi all,

I've been diagnosed with PMR for two years now, and have weaned myself down to 7 mg per the slow taper method that many of us have been using.  Actually, it has been very manageable with few problems.

Yesterday, however, during a routine eye exam I was told that my glaucoma readings were very high -- and that I was high risk of that disease.

Do any of you know of any relationship between prednisone use and glaucoma (or PMR and glaucoma)?

Thanks for all your help -- what a group!

0 likes, 16 replies

16 Replies

  • lodgerUK_NE
    lodgerUK_NE bob73443

    Posted

    I cannot answer your question about relationship - but no doubt someone will have an answer.

    However as PMR is very closely related to GCA, that can and does occur - but not freuqently.   The opticians always keep a close eye out for cataracts which can come along with use of pred and other medications, apart from occurring naturally.

    What I can tell you that when first diagnosed with GCA, the opthamologist spotted the beginning of cataracts, however although on pred for five years and in remission for 6 and counting, those cataracts have hardly grown at all.  

    Now they now about the glaucoma, they will keep a good watch out and so will you.  With a bit of luck and a fair wind, it may not develop at all.

     

    • elizabeth53956
      elizabeth53956 lodgerUK_NE

      Posted

      I don't know anything at all about it, but I did read someplace that it can occur and I think the article said infrequently.  I wish you well, and I know that my concern was arteritis which has to do with loss of vision and I stayed in the fear of that for a long time because I do have swelling in my temples and I am such a visual person that I was very fearful. Then last week I talked with someone about my fear, and I'm really trying to give up my fear. Hopefully you will find a physician who can treat you, and you will have a good outcome. I do know that I carried the fear for a long time. Way before I got this diagnosis. I just have to stay out of fear. It was robbing me of my peace, and I was getting quite upset. We need to remain as clear headed as possible, and just find good treatment
    • lodgerUK_NE
      lodgerUK_NE elizabeth53956

      Posted

      Elizabeth

      You know the symptoms of GCA and have them in your head so stop worrying about GCA - if any of those symptoms appear, you know exactly what you do.  Off to A&E and up the pred.

      There is light at the end of the tunnel, we just don't know how long the damn thing is. rolleyes

    • bob73443
      bob73443 elizabeth53956

      Posted

      Elizabth,

      Thanks for your talk about fear.  It's something I suppose all of us must deal with in one way or another.  You were correct in relating this to my post.  Glaucoma (and GCA) are scary prospects.  We're all learning differnt things, but one of the things I'm learning is that this is very much a faith journey.  As you suggested, I (we) need to stay out of fear and learn to Trust.

      Thanks Elizabeth.

  • paula63201
    paula63201 bob73443

    Posted

    Yes. Good idea to check for glaucoma when on long term Prednisone. I believe it can be one of the side effects. Not everyone gets it, but if you do have it, you need treatment.

    Check out the website of the American Academy of Opthalmology. Steroid Induced Glaucoma is the title of the article.

    All the best.

    Paula

  • EileenH
    EileenH bob73443

    Posted

    Pred can lead to raised eye pressure - but that on its own is NOT glaucoma, it is just one of a few criteria that have to be fulfilled for a diagnosis of glaucoma and you can have raised pressures and no glaucoma and glaucoma without raised pressures:

    https://patient.info/health/glaucoma-chronic-open-angle

    Your optician should now keep an eye (sorry redface  ) on your pressures and when they reach a particular threshold you should be given eye drops which should control the pressure so it doesn't get worse. 

    Not everyone on pred has the problem, not everyone who develops glaucoma is on pred. Is there any glaucoma in your family? If so you should be monitored anyway and it is supposed to be covered by the NHS. The recommendations are checks every year - but that was changed a bit back I suspect. But the peanuts charge for an eye exam in the UK is worth every penny. Here I have to go to the hospital, the waiting lists are long - and I am very naughty...

    • elizabeth53956
      elizabeth53956 EileenH

      Posted

      Yesterday I read this, went to the phone called my retina specialist, and they moved my appt. from June to tomorrow. That will give me peace of mind, and it was an easy thing to do. Just 2 days on the site, and I'm also considering changing my doc.  I really like her a lot, but there were lots of mis-steps.  I had a doc before her who I liked a lot, and I might just go back to her.
    • Judyg
      Judyg EileenH

      Posted

      Hello Eileen,  this is nothing to do with this particular discussion as such, 

      i have somehow managed to delete a discussion from a lady who was asking about Msm' for her Mum. My interest was your very helpful suggestions re tapering prednisolone and a web addresses.

      Is there any chance you could forward these to me please.

      i see my GP tomorrow and she think reducing pred at 2.5 per week slow.  

       

    • EileenH
      EileenH Judyg

      Posted

      This link you mean?

      https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316

      Web addresses in the first post, my "dead slow and nearly stop" approach to reduction in the replies. This thread is a fixed one at the top of the list of forum discussions on the "front page" of the PMR/CGA forum - where you can also see every thread there's been. Ever!

      https://patient.info/forums/discuss/browse/polymyalgia-rheumatica-and-gca-1708

      Or you can get to it by scrolling to the top of this page where you will see

      Home > Discussion Forums > Bones, joints muscle > Polymyalgia rheumatica

      all in red type. Click on the poly bit and it takes you there.

    • Judyg
      Judyg EileenH

      Posted

      Thank you Eileen, so comforting  to know there is someone who appears to know exactly what they are talking about.  

      Yes those were the links, how I deleted them I will never know, I'll put it down  to pred brain., ( they do have their uses) so many horrible side effects, however have tried methotrexate in the short term not good either!

  • MrsO-UK_Surrey
    MrsO-UK_Surrey bob73443

    Posted

    Bob, high doses or long-term use of prednisolone can cause glaucoma.  However, as you say you were told that you were at "high risk of that disease", I'm assuming that you haven't actually been diagnosed with glaucoma itself at this stage?  It sounds as though your eye exam revealed high eye pressures?  High pressures in themselves do not necessarily lead to glaucoma but the pressures need to be treated with the relevant pressure-reducing drops to reduce that risk.  Some people are diagnosed with glaucoma in spite of having normal eye pressures.  If your high pressures are steroid-induced, then perhaps there is a chance that once off steroids the pressures will improve.
  • Anhaga
    Anhaga bob73443

    Posted

    I have raised ocular pressure so that I now go to my eye doctor every few months instead of every two years.  It was a marked increase caused by prednisone as my eye pressure had been the same for years before that.  My next appointment is in a couple of weeks - hoping things have improved as dose is lower.
    • bob73443
      bob73443 Anhaga

      Posted

      Anhaga and all,

      Thank you for your response.  I could not find anything definitive on the internet about this, and through all your comments now I know there's a link.  I hope your ocular pressure goes down, Anhaga, and wish you all the best.

    • Anhaga
      Anhaga bob73443

      Posted

      Thanks Bob - and good wishes to you too!
  • rahlf43
    rahlf43 bob73443

    Posted

    I just found this post on PMR,GCA and glaucoma and wonder if anyone has found out anything new regarding the relationship between PMR and glaucoma. We are in the US and so far I haven't learned much from the specialists involved in my care and haven't found any literature that there is a meaningful relationship that could lead to better coordinated care, especially if both conditions are diagnosed concurrently.

    Please advise if there is anything new.

    • EileenH
      EileenH rahlf43

      Posted

      They aren't linked specifically if that is what you mean. 

      The first sign of glaucoma is raised occular pressure. If the pressure is too high for too long it damages the optic nerve and once a couple of other criteria are fulfilled the diagnosis progresses from merely raised pressures to actual glaucoma with loss of peripheral vision. There are various causes and types of glaucoma and it can develop slowly over time with no obvious symptoms - unless you have the pressures measured - or it can develop acutely, suddenly with pain and symptoms which require immediate treatment to avoid permanent damge.

      Pred can cause raised occular pressures so we should be monitored for that. Up to a certain level it requires monitoring, above a given pressure treatment is required. If it isn't identified then the pressure can cause the same sort of damage as happens when primary glaucoma develops but in this case it is secondary to pred use.

      The care for potential glaucome is the same whether you have a family history of glaucoma, in which case you are at an increased risk of developing it, or whether you are just on pred. Your occular pressures need to be monitored, really at least annually. You are on pred? You need your pressures checked. That's all really.If they are found to be raised - then you need care. 

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