Can Meloxicam Cause Glaucoma?
No, meloxicam does not cause or increase the risk of developing glaucoma in humans. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is not associated with glaucoma development based on current clinical evidence and guidelines.
Evidence from Guidelines and Research
NSAIDs and Glaucoma Risk
Corticosteroids, not NSAIDs, are the primary medication class associated with glaucoma development. The American Academy of Ophthalmology identifies long-term oral or inhaled corticosteroids as significantly increasing the risk of cataract formation and glaucoma, particularly posterior subcapsular changes 1, 2.
Drug-induced glaucoma is primarily caused by glucocorticoids, not NSAIDs. The major medication classes that can induce or precipitate glaucoma include corticosteroids (for open-angle glaucoma) and anticholinergics, adrenergic agonists, certain antidepressants, sulfonamides, and topiramate (for angle-closure glaucoma) 3, 4.
Topical NSAIDs are mentioned in ophthalmology guidelines only as potential causes of corneal complications, not glaucoma. The American Academy of Ophthalmology notes that topical NSAIDs can cause corneal melting or perforation and are listed among medications that may cause keratoconjunctivitis, but glaucoma is not mentioned as a risk 1.
Limited Animal Study Data
- One veterinary study in healthy dogs found a statistically lower intraocular pressure (IOP) with meloxicam compared to gabapentin or tramadol, but this difference was not clinically meaningful. The authors concluded this effect warrants further investigation at higher doses or in animals with existing glaucoma, but no human data supports this concern 5.
Clinical Context
Medications That Actually Cause Glaucoma
The following medication classes have established associations with glaucoma development:
Corticosteroids (topical, periocular, systemic, or inhaled) increase IOP in 18-36% of the general population and 46-92% of patients with primary open-angle glaucoma 6, 7.
Anticholinergics, adrenergic agonists, selective serotonin reuptake inhibitors, tricyclic antidepressants, anticoagulants, and histamine receptor antagonists can precipitate acute angle-closure glaucoma in predisposed individuals with narrow anterior chamber angles 3, 4.
Important Caveats
Topical NSAIDs used after ocular surgery require monitoring for corneal complications, not glaucoma. Short courses with close follow-up are recommended due to concerns about corneal melting or perforation, particularly in high-risk patients 1.
Patients on glaucoma medications who use topical NSAIDs may experience medication-induced keratoconjunctivitis from the combination of multiple eye drops and preservatives, but this is a surface disease, not glaucoma progression 1.