A patient receiving long-term topical prednisolone drops after corneal transplant develops bilateral elevated IOP with open angles. The mechanism of steroid-induced glaucoma is:
- A Increased aqueous humour production by the ciliary body
- B Deposition of glycosaminoglycans in the trabecular meshwork reducing outflow facility ✓
- C Forward displacement of the lens-iris diaphragm
- D Neovascularisation of the drainage angle
Correct answer: B. Deposition of glycosaminoglycans in the trabecular meshwork reducing outflow facility
Explanation
Corticosteroids increase resistance to aqueous outflow through the trabecular meshwork, thought to result from accumulation of glycosaminoglycans and other extracellular matrix material in the juxtacanalicular tissue. Susceptibility varies genetically, with steroid responders showing the greatest rise. Aqueous production is not increased, neovascular glaucoma requires ischaemia such as diabetes or central retinal vein occlusion, and angle closure mechanisms do not apply here since the angles are open.
Reference: Shields Textbook of Glaucoma, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.