Crohn’s Disease and Glaucoma
By Vonda Sines
Published Sep 14, 2013
On the day when I received a diagnosis of Crohn’s disease, I had no idea I would ever mention that ailment and glaucoma in the same sentence. However, my doctors are mentioning it more and more often as the years go by.
What’s the connection?
Glaucoma is one of the potential Crohn’s complications that occur outside the gut. There are at least two ways in which Crohn’s patients can develop this eye condition.
One of the vision complications that occur most often is uveitis, which is an inflammation of the middle layer of the eye wall. Patients typically report pain, redness, light sensitivity and/or blurred vision. If uveitis isn’t treated, it can progress to glaucoma.
Crohn’s patients can also develop glaucoma after taking corticosteroids for a prolonged period. Extended use of these drugs, which are very successful at reducing inflammation in the gut, can also lead to cataracts, high blood pressure and bone thinning in addition to shorter-term side effects like emotional swings.
So what’s the big deal about glaucoma?
Glaucoma is actually an umbrella term for a group of diseases that can cause vision loss and blindness because of damage to the optic nerve. While there is no cure, if doctors detect it early, they are often able to offer treatment that slows the progression of the disorder.
Many people associate this condition with increased eye pressure. However, it’s possible to develop glaucoma while having normal pressure in both eyes.
In my 30s, I remained on various doses of oral steroids for 2 ½ years. At 39, I learned I had cataracts. Ironically, because I’ve been on drugs that intentionally suppress my immune system since 1992, doctors are now reluctant to remove the steadily growing cataracts. They fear that due to suppressed immunity, my eyes might not heal satisfactorily after cataract surgery.
About five years ago, my ophthalmologist started frowning after measuring the pressure in my eyes. Since my 2 ½-year stint on steroids, I’ve tackled other Crohn’s flares with corticosteroids in addition to my normal arsenal. One steroid was supposed to spare me most of the adverse effects associated with this class of drugs. However, I still developed several of them.
The pressure in my eyes hovers on the borderline between the readings for one common type of glaucoma and the top of the normal range. With each yearly computer scan, the optic nerve in each eye is thinner. Since I also have dry macular degeneration, I find each vision appointment a bit stressful.
We watch. And we wait.
If you have Crohn’s disease, you shouldn’t obsess about developing glaucoma. The link between having this digestive disease and the risk of developing loss of vision is a reminder that with some drugs and some conditions, there is no free ride when it comes to avoiding complications.
Instead of worrying, be proactive. Ask about potential side effects whenever a healthcare provider suggests using a new medication or a different combination of drugs.
If you decide to accept any risks indicated, make sure to tell all your medical providers about the medications you take, how much you take and how long you’ve taken them. Then follow their recommendations about getting screened for any possible complications like glaucoma.