Corticosteroids—glucocorticoids, topical, eye

Eye-drops

Glucocorticoids that have been used for local ophthalmic treatment as eye-drops include medrysone, fluorometholone, tetrahydroxytriamcinolone, and clobetasone. Loteprednol etabonate 0.5% increases intraocular pressure less than dexamethasone. Studies on animal models of uveitis and two randomized double-masked trials have shown that loteprednol etabonate 0.5% is less potent than dexamethasone, prednisolone acetate 1%, or fluorometholone, which may partly explain the improved toxicity profile of loteprednol etabonate [ ].

Clinicians should not prescribe glucocorticoid-containing eye-drops unless they have performed a slit-lamp examination with tonometry, have assurance of appropriate follow-up, and understand the differential diagnosis, evaluation, and treatment. Unless clearly indicated, prescribing volumes larger than 5 ml or providing refillable prescriptions should be avoided. It should be stressed that excessive use of glucocorticoids can result in corneal Herpes infection and mycosis.

Sub-Tenon local injection

Sub-Tenon local injection of a glucocorticoid is effective in the treatment of certain forms of uveitis.