Corticosteroids are anti-inflammatory compounds. Any stress, injury or surgical trauma to the eye results in inflammation. This can be treated by non-steroidal anti- inflammatory drugs (NSAIDs) or corticosteroids. Corticosteroids play a prominent role in treating inflammatory conditions of eye. Often, they are used in combination with other anti-microbial agents.
Several corticosteroid compounds are used in eye conditions they are classified according to their potency as mild, moderate and highly potent corticosteroids.
Mild potent corticosteroids, such as hydroscortisone are used for the superficial non-infectious inflammatory condition of the eyes such as blepharitis and conjunctivitis (inflammation of eyelids and conjunctiva, respectively) of mild severity.
Moderately potent corticosteroids including betamethasone are used for moderate inflammatory conditions such as inflammation of lining of cornea, localized superficial inflammation of sclera, and moderate inflammation of eyelids as well conjunctiva.
Highly potent corticosteroids are used for severe and deep sited inflammatory condition or when the rapid response is desired and some of them include dexamethasone, prednisolone and fluorometholone.
The selection of the corticosteroids depends on their potency as well the severity of the inflammation. Usually short-term usage of 1-3 weeks is preferred. In addition to corticosteroids, topical antibacterial products are also given to reduce the risk of secondary infections. For inflammation of the external eye, a follow up visit is scheduled at second or third day of starting the corticosteroid treatment to assess whether the inflammation is responding to the given corticosteroid treatment. If not, your ophthalmologist may change the corticosteroids prescribed earlier. For more severe cases of inflammation you will be asked for follow-up visit at 2nd and 7th day and then after every 4th to 7th day till the condition resolves.
The treatment with corticosteroids should never be stopped abruptly unless your ophthalmologist suggests or if you experience severe side effect with the currently using corticosteroids. The use and dose of the corticosteroids is slowly reduced in the second or third week depending on the improvement. It is called as tapering the corticosteroids treatment. Corticosteroids should not be given in case the redness of the eye is due to fungal, protozoal or, active tuberculosis infection and in case of certain viral infections especially active herpes simplex infection.
Patients using corticosteroids must practice certain measures to avoid the further complications.
- Corticosteroids are intended for short-term use only therefore do not continue the treatment beyond specified period unless specified your physician
- If the inflammation does not resolve in 7 days, please consult your physician immediately
- Discard the corticosteroid preparation after your use, they are not supposed to re-use once the container is opened for more than 4 weeks
- You may experience side effects such as mild irritation or stinging effect and if the side effects persist for longer duration consult your physician immediately
- Discuss with your physician before using the corticosteroids if you are pregnant, have glaucoma, other infections in eye, using contact lenses, or using other medications and if you had any allergic reaction earlier to the prescribed corticosteroid
- Use of corticosteroids may cause increase in intraocular pressure and may facilitate the development of cataract in some patients
Despite their side effects corticosteroids are the preferred choice of eye specialists to treat inflammatory conditions.