Elevation of intraocular pressure (IOP) due to therapeutic use of glucocorticoids is called steroid-induced ocular hypertension (SIOH); this can lead to steroid-induced glaucoma (SIG). Glucocorticoids initiate signaling cascades ultimately affecting expression of hundreds of genes; this provides the potential for a highly personalized pharmacological response. Studies attempting to define genetic risk factors were undertaken early in the history of glucocorticoid use, however scientific tools available at that time were limited and progress stalled. In contrast, significant advances were made over the ensuing years in defining disease pathophysiology. As the genomics age emerged, it appeared the time was right to renew investigation into genetics. Pharmacogenomics is an unbiased discovery approach, not requiring an underlying hypothesis, and provides a way to pinpoint clinically significant genes and pathways that could not have been discovered any other way. Results of the first genome-wide association study to identify polymorphisms associated with SIOH, and follow-up on two novel genes linked to the disorder, GPR158 and HCG22, is discussed in the second half of the article. However, knowledge of genetic variants determining response to steroids in the eye also has value in its own right as a predictive and diagnostic tool. This article concludes with a discussion of how the Precision Medicine Initiative^®, announced by U.S. President Obama in his 2015 State of the Union address, is beginning to touch the practice of ophthalmology. It is argued that SIOH/SIG may provide one of the next opportunities for effective application of precision medicine.

由于糖皮质激素的治疗​​用途而引起的眼内压升高（IOP）被称为类固醇诱发的高眼压症（SIOH）；这会导致类固醇诱发的青光眼（SIG）。糖皮质激素启动信号传导级联反应，最终影响数百个基因的表达。这提供了高度个性化的药理反应的潜力。试图确定遗传危险因素的研究是在糖皮质激素使用史的早期进行的，但是当时可用的科学工具有限，进展停滞了。相反，在随后的几年中，在定义疾病病理生理学方面取得了重大进展。随着基因组学时代的到来，似乎是时候重新进行遗传学研究了。药物基因组学是一种无偏见的发现方法，不需要基础假设，并提供一种方法来查明其他方法无法发现的具有临床意义的基因和途径。文章的后半部分讨论了第一个全基因组关联研究的结果，该研究鉴定了与SIOH相关的多态性，并跟踪了与该疾病有关的两个新基因GPR158和HCG22。但是，了解决定眼睛对类固醇反应的遗传变异知识本身也具有作为预测和诊断工具的价值。本文以“精确医学计划”的讨论为结尾 GPR158和HCG22，将在本文的后半部分中讨论。但是，了解决定眼睛对类固醇反应的遗传变异知识本身也具有作为预测和诊断工具的价值。本文以“精确医学计划”的讨论为结尾 GPR158和HCG22，将在本文的后半部分中讨论。但是，了解决定眼睛对类固醇反应的遗传变异知识本身也具有作为预测和诊断工具的价值。本文以“精确医学计划”的讨论为结尾^®，美国总统奥巴马在他的国情咨文2015年国家宣布，已开始触及眼科的做法。有人认为，SIOH / SIG可能会为有效应用精密医学提供下一个机会。