Meloxicam Does Not Worsen Glaucoma Symptoms
Meloxicam, as an NSAID, does not worsen glaucoma symptoms and is not associated with increased intraocular pressure or glaucoma progression in humans. 1
Evidence-Based Rationale
NSAIDs Are Not Implicated in Glaucoma Risk
The American Academy of Ophthalmology clearly identifies corticosteroids—not NSAIDs—as the medication class that significantly increases the risk of glaucoma by raising intraocular pressure. 1 This distinction is critical because:
Corticosteroids (not NSAIDs) are the major medication class that can induce or precipitate glaucoma, with approximately 18-36% of the general population being corticosteroid responders, increasing to 46-92% in patients with existing primary open-angle glaucoma. 2
The American Academy of Ophthalmology specifically notes that topical NSAIDs can cause corneal melting or perforation with prolonged use, but glaucoma is not mentioned as a risk associated with NSAID therapy. 1
Medications That Actually Cause Glaucoma
When considering drug-induced glaucoma, the focus should be on:
Corticosteroids (topical, oral, or inhaled) which increase IOP through morphological and functional changes in the trabecular meshwork system 3, 2
Sulfa drugs which can cause bilateral non-pupillary block closed-angle glaucoma due to forward movement of the iris-lens diaphragm 4
Medications with sympathomimetic or parasympatholytic properties that can cause pupillary block closed-angle glaucoma in individuals with narrow iridocorneal angles 4
Clinical Context for Meloxicam Use
Meloxicam can be used safely in patients with glaucoma, but attention should be directed toward:
Cardiovascular and gastrointestinal risks rather than ocular concerns, as NSAIDs increase risks of myocardial infarction, stroke, heart failure, hypertension, and GI bleeding 5
Using the lowest effective dose for the shortest duration to minimize systemic adverse effects 5
Monitoring blood pressure and renal function in patients with preexisting conditions, not intraocular pressure 5
Common Pitfall to Avoid
Do not confuse the well-established glaucoma risk from corticosteroids with NSAIDs like meloxicam. While both are anti-inflammatory medications, only corticosteroids require monitoring for corticosteroid-induced increased IOP. 1, 3