Steroid-induced ocular hypertension with loteprednol etabonate 0.2%--a case report.

The aim of this study was to present a case of a patient who showed a significant increase in intraocular pressure (IOP) with topical administration of loteprednol etabonate 0.2%. A 29-year-old man administered 1 drop of loteprednol etabonate 0.2% (Alrex(®)) to both eyes 4 times a day for 3 days as an off-label treatment for chronic red eye. By the third day of treatment, IOPs increased to 50 mmHg in each eye. The patient had no previous history of glaucoma. Gonioscopy found open angles in each eye. IOP returned to normal levels after discontinuation of Alrex. Steroid response in the same patient was confirmed on a second trial of Alrex. Although loteprednol etabonate has been shown to have a minimal effect on IOP in most patients, close follow-up is necessary whenever therapy is initiated.