What is Corticosteroids?

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 the 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 hydrocortisone 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 the lining of the cornea, localized superficial inflammation of the sclera, and moderate inflammation of eyelids as well conjunctiva.
  • Highly potent corticosteroids are used for severe and deep sited inflammatory conditions 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 as 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 on the 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 a follow-up visit on the 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 effects with the currently using corticosteroids. The use and dose of the corticosteroids are slowly reduced in the second or third week depending on the improvement. It is called tapering the corticosteroid 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 further complications.

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