A patient is started on betamethasone eye drops four times daily for allergic conjunctivitis. As per standard classification used in Indian textbooks, a 'steroid responder' is defined by which intraocular pressure change?

• A Any rise of intraocular pressure above 21 mmHg at any time during therapy
• B An intraocular pressure exceeding 30 mmHg regardless of duration of therapy
• C A rise of more than 10 mmHg above baseline after six months of continuous therapy
• D A rise of more than 5 mmHg above the pretreatment baseline after three weeks of therapy ✓

Explanation

Following the Armaly and Becker classification adopted in Indian texts such as Khurana and Parsons, a rise of more than 5 mmHg above the individual baseline after about three weeks of topical corticosteroid marks a responder. About one third of the general population are intermediate responders and roughly 5 percent are high responders. Option A is wrong because a modest rise within normal limits does not define responsiveness; the change must be measured against the patient's own baseline.

Reference: Khurana AK, Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.