Ocular effects of long term use of topical steroids among children and adolescents with vernal keratoconjunctivitis: a prospective observational study.

Topical steroids were often irrationally used on long term basis for quick relief from ocular discomfort of inflammatory eye conditions like vernal keratoconjunctivitis in spite of their well known deleterious ocular effects. The present study was undertaken to determine the ocular effects of long term use of topical steroids among the patients with vernal keratoconjunctivitis and also to evaluate the ocular responses after withdrawal of steroids. The prospective observational study was carried out in a tertiary eye care centre of West Bengal. A total 150 referred patients of vernal keratoconjunctivitis, those used topical steroids for more than a month were included in the study. A complete set of ophthalmic examinations including measurement of intra-ocular pressure and visual acuity was carried out during registration. After withdrawal of steroids, the patients were followed-up periodically and finally evaluated after 8 weeks for any Improvement of Intra-ocular pressure and best corrected visual acuity. The data was analysed by SPSS 12.0.1 software package. Proportions were used for Interpretation. Paired t-test was used for comparison between two proportions (before and after withdrawal of steroids) and p-value <0.05 was considered as the level of significance. Though ropy mucus discharge with minimal conjunctival involvement was found the most common (74.7%) ocular manifestation, grave consequences like glaucoma was also evident among 8.7% of the study participants. Significant improvements (p<0.05) were observed for both reduction of intra-ocular pressure and visual acuity after 8 weeks of withdrawal of topical steroids. Topical steroids should be used cautiously with periodic ophthalmic examinations including intra-ocular pressure.