Dexamethasone induced glaucoma as part of chemotherapy for T cell lymphoblastic lymphoma

Purpose To describe glaucoma after high dose corticosteroid chemotherapy in an 11-year-old girl. Methods Topical steroids are well known to induce a rise in intraocular pressure, but responses to oral steroids are rare. We report a significant elevation in an 11-year-old girl following high dose dexamethasone treatment as part of her chemotherapy for T cell lymphoblastic lymphoma. Results Six days after initiation of her first cycle of chemotherapy including oral dexamethasone 4.5 mg bd she presented with headaches, photophobia and blurring of vision. Intraocular pressures IOP were 48 and 52 mm Hg in the right and left eye respectively. Control of IOP was achieved medically, although systemic carbonic anhydrase inhibitor use necessitated admission to intensive care for renal support. Conclusions Vision threatening IOP rise may be a complication of high dose oral dexamethasone treatment. Routine screening of children undergoing this type of chemotherapy may be indicated.