Chronic Topical Steroid Use and Uncontrolled Steroid-Induced Glaucoma
Chronic Topical Steroid Use and Uncontrolled Steroid-Induced Glaucoma
Expert analysis assessed whether the glaucoma specialist's failure to obtain an adequate medication history and coordinate with the treating dermatologist constituted a breach in the standard of care.
Case Summary
Evaluated a case involving a patient on long-term topical steroid therapy prescribed by her dermatologist who simultaneously presented to a glaucoma specialist with uncontrolled glaucoma, raising questions about interdisciplinary communication and medication management.
Background
Ms. X had been using topical corticosteroids prescribed by her dermatologist for several years. Concurrently, she was under the care of a glaucoma specialist for uncontrolled glaucoma, with the possibility that she was a steroid responder. The glaucoma specialist’s failure to identify and address the topical steroid use became the central issue in this matter.
Expert Analysis
- Review of records from both the dermatologist and glaucoma specialist
- Assessment of the glaucoma specialist’s intake and medication history documentation
- Evaluation of the standard of care regarding medication review in glaucoma management
- Analysis of whether a steroid-responder workup was appropriately considered
- Review of the duty to communicate between treating specialists in a shared-care scenario
- Assessment of whether earlier identification of steroid use could have altered the clinical course
Testimony Provided
Provided expert opinion on whether the glaucoma specialist’s failure to obtain a thorough medication history and communicate with the dermatologist regarding chronic topical steroid use constituted a breach in the standard of care.