blue eye

Hi Friends!


I'm so happy that it is spring and warm weather is around the corner.  I'm looking forward to weaning off my Hydrocortisone over the next few months.  An eternal optimist, I pray that I do not have any more setbacks in reaching this goal.



Today I want to talk about the importance of seeing an ophthalmologist as soon as you start taking steroids.  I'm not talking about your yearly exam with an optometrist.  Read on to see the difference and importance of adding this knowledgeable medical provider to your team.


You may be asking, what does eye health have to do with your steroid treatment?



For those who struggle every day with pain and auto-immune health issues, adding another worry such as eye problems can be overwhelming.


Dealing with unrelenting discomfort, stiffness, and fatigue can be challenging enough for those with an auto-immune condition such as Polymyalgia Rheumatica.


If steroids are part of the treatment plan, most of us are aware of a plethora of obvious problems that arise due to this little helpful (yet hurtful) pill. 


A few issues we face every day are:

  • Weight gain 
  • Moon face 
  • Buffalo hump 
  • Stomach upset 
  • Compromised immune system 
  • Wrinkly and thin skin,
  • Hair thinning and loss 
  • High blood pressure 
  • Diabetes 
  • Emotional upheaval 
  • Sweats then chills 
  • Highs and lows of all sorts


But there is a silent yet very serious side effect of long-term steroid use that you may not be aware of.  


The fact is that steroids can damage the eye in many ways.




I’m not talking about occasional blurry vision or needing stronger glasses. Steroids can cause glaucoma, cataracts, and nerve and wall damage to the eye.


This destruction can be swift and, in some instances, irreversible if left untreated. Blindness can ensue. Unfortunately, your doctor may not have warned you about this crucial fact.



So, if you are taking any steroids to treat your condition, it is essential that you see an ophthalmologist as soon as you begin steroid use. Then continue to be monitored by this provider as recommended.


Old age has nothing to do with developing steroid-induced eye complications. Children and young adults should be followed as well if undergoing long-term steroid treatment.


I'm not insinuating that steroids are bad or that you should not treat your condition with this life-saving medication.  I just want you to be aware of the side effects and know how to protect and monitor this very important organ of ours.



Most of us treat with an optometrist for our day-to-day vision and eye checks. But there is a difference between an optometrist and an ophthalmologist. An ophthalmologist focuses more on the medical aspect of eye health vs. an optometrist who primarily manages your vision. There is a lot of overlap between these provider types but important differences also.


An ophthalmologist is recommended due to the potential for extensive harm to our eyes from prolonged steroid use. Once you are in the capable hands of a knowledgeable ophthalmologist, they should handle any eye issues that develop.


Let me tell you my eye story to illustrate the importance of seeing an ophthalmologist “tout suite”!



A few weeks before my diagnosis of Polymyalgia Rheumatica, I went for my routine eye exam with my gentle and sweet optometrist of many years. After checking my eyes, my beloved optometrist pronounced excellent eye health.  I did not have any cataracts, and my eye pressure was normal.


Fast forward 2 months, and I was diagnosed with PMR and started on 20 mg of Prednisone a day.


From my research on PMR, I knew that there is a severe eye condition that sometimes goes hand in hand with it. Temporal Arteritis, otherwise termed Giant Cell Arteritis (GCA), develops in up to 30% of folks with PMR. If you PMR and are not familiar with GCA, I advise that you become knowledgeable on this medical disorder.



Since I was concerned about the potential for developing GCA, I decided to make an appointment with my parents' trusted ophthalmologist. Having never been to an ophthalmologist, I expected the evaluation to be similar to my previous experiences with my regular eye doctor. In many ways, it was. But also, it was a whole lot more.


This doctor knew all about my overall health by just looking into my dilated eye. She could tell if I ever had a blood pressure spike, diabetes, eye disease, and much more. She was very knowledgeable about long-term steroid use and its effect on the eyes and body and educated me beyond my research.  She taught me much more about PMR and steroid treatment than my medical doctors shared.



What she did not find was GCA, thankfully.


I thought my exam would end at that point, but she had a LOT more to tell me.


I was shocked and upset to hear that I had very high eye pressure and had developed prednisone-induced glaucoma. In addition, I had some damage to the nerves in my eyes and the back of my eyewall. She said it looked “like a firehose had been aimed at the back of my eye”, causing some crushed wall. 


That was a graphic yet effective lesson for me.



If that was not enough, it was also determined that I was developing Prednisone-related cataracts. As my doctor explained, these cataracts are different from “old age” cataracts. Prednisone-induced cataracts are thicker and deeper. Greeeeeat…


All this, in just 2 months on the “Roids”!


I was instructed to start eye drops immediately to reduce the eye pressure and glaucoma. Once the eye pressure is under control, further damage should be minimal. She would continue to track my cataracts as they were not “ripe “enough for surgery. Unfortunately, there is no cure for cataracts besides eventually removing them.



I left that appointment in shock and yet grateful. I was grateful that I knew enough to seek the expertise of an ophthalmologist, even if it was to only check for GCA. Grateful that she caught my eye issues in time before more severe damage could take place. Grateful that the eye drops should help to save my vision.


I suspect that I stumbled upon an excellent ophthalmologist. But maybe they all are just as helpful and knowledgeable due to their expertise in this field.


So please, seek out an ophthalmologist as soon as you begin your steroid treatment. Even if you get a clean bill of health, you will know that your eyes are in the right hands.



Take care, my warrior friends!