Safety of Intranasal Corticosteroids in Glaucoma Patients

Introduction to Safety Profile

The American Academy of Allergy and Clinical Immunology recommends that patients with glaucoma can safely use Flonase (fluticasone propionate nasal spray), as intranasal corticosteroids at recommended doses do not increase the risk of glaucoma or elevated intraocular pressure 1

Patients receiving standard doses of intranasal corticosteroids are not at increased risk for the development of glaucoma, according to the American Academy of Otolaryngology-Head and Neck Surgery 1
Long-term use of intranasal steroids has not been shown to increase the risk of elevated intraocular pressure or any other ocular symptoms, as stated by the American Academy of Otolaryngology-Head and Neck Surgery 2
Studies of intranasal corticosteroids in prospective trials of 24 weeks have not demonstrated the development of lenticular changes consistent with posterior subcapsular cataracts, according to the American Academy of Allergy and Clinical Immunology 1

Patients on long-term topical nasal steroids should consult their physicians to determine if regular ophthalmic monitoring is appropriate, as recommended by the American Academy of Otolaryngology-Head and Neck Surgery 2
No routine monitoring is required for short-term use (less than 12 weeks), according to the American Academy of Allergy and Clinical Immunology 1
Patients should be instructed on proper administration technique to optimize local delivery and minimize systemic effects, as stated by the American Academy of Otolaryngology-Head and Neck Surgery 2

Patients with glaucoma who are already under ophthalmologic care should maintain their existing IOP monitoring schedule (typically every 3–6 months) and do not require additional visits solely because they are using intranasal fluticasone. This recommendation is based on evidence from two 2016 Ophthalmology publications. 3, 4