Restarting tapering

[Groggrim]

My doctor has been quite relaxed about my tapering of prednisolone. However my optician is more concerned that I reduce because it is affecting my eyes, the cataract and pressure in the eye. I trust my optician and will restart the reducing plan. Has anyone else had eye issues as a result of taking steroids?

[DorsetLady PMRGCAuk volunteer]

Listed as side effects of the Pred in the patient information leaflet [PIL] - and surprised optician/optometrist isn’t aware of that… and tapering will help, but you still enough to control PMR.

[PMRpro Ambassador]

There are lots on the forum who have had cataracts develop and removed after starting pred, it doesn't have that effect for everyone though. Pressures do also often rise so it is recommended that all patients on pred have an annual check.

There are drops for the pressures - and once the cataract has started to develop it won't go away. It depends to some extent whether this IS PMR - if it is and you go too low, the symptoms return so it is a balance between managing all the aspects like everything to do with PMR/GCA

[piglette]

You should reduce slowly which works for you. Usually people start based on what is recommended by their doctor, but over time we tend to find out what works best for us. Some people can reduce really easily and the others the total opposite. Under 10mg usually 0.5mg every month or so, although that can get slower when the adrenals start to wake up.

[Groggrim in reply to piglette]

Hello, I just read your post properly after having a very busy few days which has left me feeling like a wrung out old dishcloth. It makes such sense but I feel trapped between my doctor and optician who both want me off pred pdq, and my body which is resisting my tapering and crying out for more.

[piglette in reply to Groggrim]

Your body probably talks the most sense. It is so frustrating having to talk to people who do not have PMR and just follow what the rule book says. I had a rheumatologist like that. I just left him and told my GP, who said ‘we don’t need him anyway!!’ Can you talk to your GP? Don’t taper if you are in pain.

[NellOHE3]

I was already having eye injections before PMR so changes in my vision have been carefully monitored. The Pred has caused issues with pressures and potential Glaucoma and it has been a balancing act between reducing as rapidly as possible but still keeping the PMR at bay. I have gone from 15mg to 2 mg in 9 months but am being kept at 2mg for a while now. Another two visits to the Eye Hospital on the horizon and then a review.

[PMRnewbie2017]

Yes. I developed raised intra ocular pressures detected at a routine eye test appointment. Was referred to a consultant who monitored me. As my dose decreased the pressures normalised and are still ok. I do have cataracts in both eyes which are not bad enough for removal under nhs guidelines. The cataracts have worsened over the past year. My current dose is tapering to 4.5mg pred. Sadly all part of being a long term Pred user.

[Excelsior80]

I have a cateract but not bad enough for surgery yet, just monitoring. May not be pred related though, my sister had worse cateracts with no pmr or pred. Thanks for reminding me to book optician appointment for next checkup 🙂

[Whiteharte]

hi yes been on prednisolone for over two years, feel have effected my eyes, but no one admits it’s prednisilone, I have Glaucoma too, just try to get down dosage ,I:got to three half few weeks back, had flare , now on 5mg, so going to wait till weather warmer, then reduce back, hate being on them, but only thing that helps,

[ChrisBeeLoop]

I had naturally occurring cataracts and was having them treated privately when I was diagnosed with PMR. I always expected to get cataracts because my Dad had them and physically we are very similar. DO NOT BE AFRAID! Cataract and hip replacementment surgery are the two most highly rated operations by their patients. My cataract surgery cost about £1500 per eye, the biggest shock being the hospital fee. The surgeon only charged a measly £995 plus consultation fees. It is quick, painless, not frightening, no you don’t see the knife, and your eyesight is amazingly better within a couple of days. The worse part of it is four weeks of tedium putting in eyedrops. I had two eyes drops four times a day. Each eye drop I had to lie still for 3 minutes, and had to leave at least 5 minutes between the two drugs, Oh! the tedium! No pain, no scariness, easy peasy.

Glaucoma I can't comment on. I just grilled my optician about it in my last eye test and he said I was fine, so far.

Going back to cataracts, most of us are of a certain age and likely to fall foul of the blighters anyway. Don’t blame it on the Pred, it's going to happen anyway. Don’t be frightened of the op, you won’t feel any pain, you won’t see the knife, but you will see the world afterwards and even be able to drive safely at night!

I would rather have the cataract op than the blasted root canal work my dentist is threatening.

[nanamandy]

Yes indeed. Eyes constantly red swollen and watery. I have occular hypertension.