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PubMed This is a summary of 16 peer-reviewed journal articles Updated
Ophthalmology

Building Your Care Team: Coordination is Key

At a Glance

Managing steroid-induced glaucoma requires a coordinated care team. Your prescribing doctor and a glaucoma specialist must work together to find a steroid-sparing treatment path, such as adjusting doses or using alternative medications, to protect your vision without sacrificing your overall health.

Managing steroid-induced glaucoma is not a solo effort; it requires a coordinated team of specialists. Because steroids are often vital for treating serious conditions—such as an autoimmune flare, asthma, or an organ transplant—your eye doctor and your prescribing doctor must work together to balance your overall health with the safety of your vision [1][2].

The Power of Co-Management

The most important part of your care is co-management. This is the process where your eye specialist (ophthalmologist) and your prescribing doctor (such as a rheumatologist, pulmonologist, or transplant surgeon) communicate directly to adjust your treatment plan [3].

The goal of this coordination is often to find a steroid-sparing path [4]. This might include:

  • Dose Reduction: Lowering the steroid to the minimum effective dose [5].
  • Alternative Medications: Switching to non-steroidal drugs, such as cyclosporine, which can control inflammation without the high risk of raising eye pressure [6].
  • Timing Adjustments: Changing when and how you take steroids to minimize the “load” on your eye’s drainage system [5].

Finding the Right Specialist

When you have steroid-induced glaucoma, you may need more than a general eye doctor. A glaucoma specialist with specific experience in complex cases is often necessary [3][7].

When vetting a specialist, look for these key qualifications:

  • Experience with Secondary Glaucomas: Ask if they have managed “steroid responders” or patients with uveitic glaucoma [3].
  • Expertise in MIGS: Ensure they are trained in Minimally Invasive Glaucoma Surgeries (such as GATT or XEN stents), which are often safer and highly effective for this condition [8][9].
  • Communication Skills: Choose a doctor who values multidisciplinary care and is willing to send detailed reports to your other physicians [10].

How You Can Help

You are the bridge between your various doctors. You can help ensure your care is seamless by:

  • Using Patient Portals: Share your lab results, medication lists, and eye pressure readings through electronic health records so all your doctors are on the same page [11][12].
  • Keeping a “Steroid Log”: Document exactly when you start or stop any steroid—including “sneaky” sources like nasal sprays or skin creams—and share this log at every eye appointment [13][14].
  • Informing Your Pharmacist: Proactively inform your local pharmacist about your “steroid responder” status. Your pharmacist often acts as a critical safety net against cross-prescribing when you see multiple specialists.
  • Self-Advocacy: Don’t be afraid to ask, “How will this new medication affect my eye pressure?” every time a doctor prescribes a steroid for any reason [15][16].

By fostering clear communication between your specialists, you can ensure that your underlying medical conditions are treated without sacrificing your long-term sight [2].

Common questions in this guide

Why do I need multiple doctors for steroid-induced glaucoma?
Managing this condition requires balancing the treatment of your underlying health issue with protecting your vision. Your prescribing doctor and your eye specialist must co-manage your care to adjust medications safely.
What kind of eye doctor is best for treating steroid-induced glaucoma?
You typically need a glaucoma specialist with specific experience in complex, secondary glaucomas. Look for a specialist who is trained in Minimally Invasive Glaucoma Surgeries (MIGS) and values multidisciplinary care.
What is a steroid-sparing treatment plan?
A steroid-sparing path involves reducing your steroid dose, changing when you take it, or switching to non-steroidal medications like cyclosporine. This helps control your underlying inflammation without raising your eye pressure.
How can I help coordinate my glaucoma care between different specialists?
Keep a detailed log of all your steroid medications, including nasal sprays and skin creams. Share this log, along with your eye pressure readings and lab results, with all your doctors and your pharmacist to ensure everyone is on the same page.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How often do you treat patients who are high steroid responders?
  2. 2.Can you provide my rheumatologist (or other prescribing doctor) with a specific report on my eye pressure to help them adjust my treatment?
  3. 3.Are you comfortable performing minimally invasive surgeries like GATT or using ROCK inhibitors if my pressure doesn't stabilize?
  4. 4.If I have an inflammatory condition like uveitis, do you have experience managing the 'pseudo-normalization' of eye pressure?
  5. 5.Will you be the one to communicate directly with my transplant or rheumatology team, or should I facilitate that through a portal?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (16)
  1. 1

    Steroid-induced glaucoma in kidney transplant recipients: a prospective cross-sectional study.

    Jain VK, Agarwal R, Maroof L, et al.

    Romanian journal of ophthalmology 2024; (68(4)):362-366 doi:10.22336/rjo.2024.66.

    PMID: 39936059
  2. 2

    Steroid-induced Glaucoma: An Avoidable Irreversible Blindness.

    Phulke S, Kaushik S, Kaur S, Pandav SS

    Journal of current glaucoma practice 2017; (11(2)):67-72 doi:10.5005/jp-journals-l0028-1226.

    PMID: 28924342
  3. 3

    Current Approach in the Diagnosis and Management of Uveitic Glaucoma.

    Muñoz-Negrete FJ, Moreno-Montañés J, Hernández-Martínez P, Rebolleda G

    BioMed research international 2015; (2015()):742792 doi:10.1155/2015/742792.

    PMID: 26558280
  4. 4

    Case series of children with steroid-Induced glaucoma.

    Lam CS, Umi Kalthum MN, Norshamsiah MD, Bastion M

    Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia 2018; (13(3)):32-37.

    PMID: 30800232
  5. 5

    Long-Term Risk of Steroid-Induced Ocular Hypertension/Glaucoma With Topical Prednisolone Acetate 1% After Descemet Stripping Endothelial Keratoplasty.

    Price MO, Price DA, Price FW

    Cornea 2024; (43(3)):323-326 doi:10.1097/ICO.0000000000003312.

    PMID: 37155339
  6. 6

    Oral Cyclosporine in Vernal Keratoconjunctivitis: Indications, Outcomes, and Effect on Corticosteroid Use.

    Kate A, Tallapelly HG, Jain N, et al.

    Cornea 2025; (44(9)):1078-1083 doi:10.1097/ICO.0000000000003786.

    PMID: 39791868
  7. 7

    Uveitic Glaucoma Interest Group Recommendations for Uveitis-Related Ocular Hypertension and Glaucoma Management.

    Pantcheva MB, Gangaputra S, Sieck E, et al.

    Ocular immunology and inflammation 2025; (33(9)):2153-2167 doi:10.1080/09273948.2025.2542286.

    PMID: 40971800
  8. 8

    Gonioscopy-Assisted Transluminal Trabeculotomy and Goniotomy, With or Without Concomitant Cataract Extraction, in Steroid-Induced and Uveitic Glaucoma: 24-Month Outcomes.

    Chen RI, Purgert R, Eisengart J

    Journal of glaucoma 2023; (32(6)):501-510 doi:10.1097/IJG.0000000000002183.

    PMID: 36795532
  9. 9

    [XEN 45® gel stent implantation in glaucoma surgery: Dual-center comparative study between steroid-induced glaucoma and primary open angle glaucoma].

    Cornée C, Orignac I, Wargny M, et al.

    Journal francais d'ophtalmologie 2022; (45(8)):872-882 doi:10.1016/j.jfo.2022.04.007.

    PMID: 35906134
  10. 10

    Team-based approach to fibromuscular dysplasia.

    Rao SJ, Kim ESH, Mitromaras C, et al.

    Seminars in vascular surgery 2025; (38(4)):395-403 doi:10.1053/j.semvascsurg.2025.10.001.

    PMID: 41386914
  11. 11

    Multifunctional Online Medical Record Use and Patient Empowerment: Examining the Mediating Role of Patient-Centered Communication Across the Life Span in the Greater China Region.

    Ye JF, Zheng S, Liu PL

    Health communication 2026; 1-13 doi:10.1080/10410236.2026.2668013.

    PMID: 42083334
  12. 12

    Unlocking potential: impact of mHealth affordance realization on patient well-being.

    Dantu R, Murad MMI

    Journal of health organization and management 2026; (40(5)):896-921 doi:10.1108/JHOM-03-2025-0133.

    PMID: 41144430
  13. 13

    The short-term effects of intranasal steroids on intraocular pressure in pediatric population.

    Ozturk T, Durmaz Engin C, Koksaldi S, Arikan G

    International ophthalmology 2022; (42(12)):3821-3827 doi:10.1007/s10792-022-02402-6.

    PMID: 35819739
  14. 14

    Risk of ocular hypertension in children treated with systemic glucocorticoid.

    Krag S, Larsen D, Albertsen BK, Glerup M

    Acta ophthalmologica 2021; (99(8)):e1430-e1434 doi:10.1111/aos.14820.

    PMID: 33629533
  15. 15

    Differences of patient empowerment between elective and contracted physicians in internal medicine in Austria: a quantitative content analysis.

    Simetsberger B, Pferzinger M, Waiguny MKJ

    BMC health services research 2025; (25(1)):476 doi:10.1186/s12913-025-12635-7.

    PMID: 40165195
  16. 16

    Level of empowerment of hospitalized patient in Taiwan clinical practice.

    Yeh MY, Wu SM, Che HL

    Journal of the Formosan Medical Association = Taiwan yi zhi 2024; (123(11)):1139-1143 doi:10.1016/j.jfma.2024.07.007.

    PMID: 38977388

This page provides information on care coordination for steroid-induced glaucoma for educational purposes. Always consult your healthcare team for medical advice tailored to your specific situation.

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