Eye issues while on prednisone and Anterma

Posted by nanniepie @nanniepie, 1 day ago

I’ve been on prednisone 15 mg since sept of 24 for PMR. Life saving. I’m now starting Acturma infusion. I had TB as a child so I have to take INH pill for 30 days. My eye pressure has increased quite a lot since all this has started and now I see a glaucoma specialist. I feel like these medications are do me a bit of harm. Any comments please.

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@nanniepie, It might be good to discuss your medications with your glaucoma specialist. Here are a couple of research articles that provide some information on the side effects.

-- Side Effects of Actemra: What You Need to Know: https://www.healthline.com/health/drugs/actemra-side-effects
-- Steroids and Glaucoma: What’s the Connection?: https://glaucoma.org/articles/steroids-and-glaucoma-whats-the-connection

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Hello, it seems like some of us react differently to drugs, thus the long list of side effects.
Are you in the US? I was wondering that because Actemra isn’t approved for PMR in the US. One rheumatologist wanted to put me on it and put down GCA as a diagnosis so Actemra would be approved. Kevzara is the biological approved for PMR in the USA.

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Prednisone definitely changes your vision. I had eye tests done every year while I was on prednisone and after I quit, then my eyesight changed again. It’s the double edged sword type of thing.

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Eye issues are probably more of a Prednisone thing than an Actemra thing. I had many additional eye issues while taking Prednisone. Ironically I first started taking Prednisone for an autoimmune eye issue called uveitis which can cause vision loss.
https://www.yalemedicine.org/conditions/uveitis#:~:text=There%20are%20several%20causes%20of,blindness%20in%20the%20United%20States.
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High doses of prednisone were used for recurrent flares of uveitis. I had rapid onset and premature bilateral cataract formation at the age of 40. Bilateral cataract formation resulted in lens replacement surgery.

It is a misnomer but I was called a steroid responder because of glaucoma. A "steroid responder" in the context of glaucoma refers to someone who experiences a significant increase in eye pressure (intraocular pressure) when taking steroid medications. Fortunately my glaucoma was only a problem when I was on prednisone for usveitis. Of course, after PMR was diagnosed, glaucoma was a problem all the time. Now that I'm off prednisone glaucoma isn't much of a problem anymore.

Neurotrophic keratitis (NK) is now my biggest worry. Nobody has suggested that prednisone caused NK but I should never take prednisone again.

"Prednisone should be used with extreme caution in cases of neurotrophic keratitis as it can significantly increase the risk of corneal melting and perforation due to its inhibitory effect on corneal healing, making its use controversial in this condition; if considered necessary, it should only be used under close monitoring by an ophthalmologist."

For this reason, an opthalmologist is very involved in my care. She is very happy that I'm on a biologic to treat PMR. My ophthalmologist would prefer a different biologic to treat uveitis. However, she is very happy that Actemra works for PMR and keeps me off of prednisone.

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