Do topical corticosteroids cause glaucoma by increasing aqueous production or reducing aqueous outflow?

Topical corticosteroids are known to contribute to the development of glaucoma primarily by reducing aqueous outflow. When corticosteroids are applied to the eye, they can lead to increased resistance to the outflow of aqueous humor through the trabecular meshwork, which is a crucial pathway for drainage of the fluid produced within the eye. This increased hydraulic resistance can subsequently result in elevated intraocular pressure (IOP), a significant risk factor for glaucoma.

The mechanism behind this effect involves the alteration of the extracellular matrix in the trabecular meshwork and possibly inflammation or structural changes induced by corticosteroids. While corticosteroids can have various effects on ocular tissues, their impact on outflow is well-documented as a primary contributor to increased IOP.

Understanding these mechanisms is essential for recognizing the risks associated with steroid use in ocular conditions and managing patients who may be predisposed to elevated IOP. Thus, the correct answer identifies the specific pharmacological effect of corticosteroids relevant to glaucoma development.