How ocular medications can cause other health complications

In an interview with dvm360, Alex Sigmund, DVM, DACVO, shares a bit about his upcoming lectures at Fetch Kansas City, where he will be discussing practical management of corneal ulcers, dry eye, and complications that can arise from ocular medications. Here, he delves into how topical steroids and dorzolamide can lead to certain health issues, including altered metabolism in the cornea, kidney problems, and dysregulation in patients with diabetes.

Registration for our Fetch dvm360 conference in Kansas City, Missouri—August 23-25, 2024—remains open! Register today to attend and learn more about eye conditions, ocular medications, and a plethora of other topics from established veterinary professionals.

Below is a partial transcript.

Alex Sigmund, DVM, DACVO: So topical steroids, when we're using them really, really frequently, can predispose [a patient] to infected ulcers. They can cause altered metabolism in the cornea that can result in fat deposits and even calcium deposits in the cornea that can lead to other issues. In [patients with diabetes], topical steroids have been shown to sometimes contribute to dysregulation. So, especially those that are getting cataract surgery, it's something that we think about when they're going to be potentially on topical steroids after surgery. And there's some research about steroids causing nasolacrimal punctal stenosis, where it narrows if you're using it all the time. So there's a few things that tropical steroids can cause, which is why I try to get patients off of tropical steroids, kind of as quickly as we can, as safely as we can, if there's an alternative.

The second one is dorzolamide, which is an antiglaucoma medication. And dorzolamide, more recently, has been shown to have some effects on the kidney, especially in cats, where it will start to actually decrease their potassium levels in their blood, which can cause some clinical signs. We've also seen that dorzolamide can cause an inflammatory response in some dogs, in their corneas and in their conjunctiva that doesn't respond to anything else except stopping the medication, and that can be a challenge for our glaucoma patients when we really only have a few medications that are even options.