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What Is The Least Powerful Ophthalmic Corticosteroid Eye Drop?

Posted on Tue, 11 Mar 2014

Question: What is the least powerful ophthalmic corticosteroid eye drop? Durezol is way more than active enough. The issue is excessive tearing and not dry eye though I think it's dry eye.

Answered by Dr. N K Mishra (4 hours later)

My Dear, Thanks for sending your query to us. As compared to betamethasone eye drops,Dexamethasone eye drops are more potent and now we have newer compounds like prednisolone acetate which are claimed to be many a times more effective.For our clinical use these are usually sufficiant as ant infllamatory agents. Stronger steroids have greater side effects,many countries have statuory warnings posted on the vial regarding development of cataract,glaucoma and fungal infections.They are most inadvisable to be used like this without proper monitoring and follow up. I in my practice have regularly seen these complications and have seen people loosing the due to this reason. A very short course of steroids if not helpfoul,then stronger steroids are unlikely to offer more. Continue with lubricating drops and there will be relief,even otherwise they are totally safe. Please do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. N K Mishra (23 hours later)

What you answered gives me some perspective. I was given a physician's sample of prednisolone acetate. I do not need anything so potent. 1 drop in the morning after 4 days stops excess tearing into the evening. But long term irritation increases from day to day while the intense burning on administration has decreased from day to day. My eyes must be sensitive as only one generic timilol brand does not irritate. Betamethasone has alarming warnings and is often formulated with an antibiotic, which leaves me apprehensive. Is there an anti-inflamatory suitable for long term use without the dangers of corticosteroids?

Answered by Dr. N K Mishra (27 minutes later)

My Dear, Thanks for getting back to us. the so called alarming warnings with betamethasone are milder as compared to other steroids.It is just this that they are following the statury warning display properly. Tjese steroids in situations like yours have a added disadvantage of being habit forming.You feel miserable without steroids thereby you are forced to continue with them thereby landing up with complications of steroid use. There are preperations with keterolac which is a NSAID ( non steroid anti infllamatory drug ) which can be used for a long period without side effects. As an adjuvant lubricant drops can also be usedfrequently. We also have to role out allergic response,so a trial of a oral anti allergic for a shhort while is given and if it helps,then we label it a theraputic response. So in nut shell you should have keterolac,lubricant eye drops and oral anti allergic tablets as and when needed. Any further query in this regard,please do get back to me and do not use steroid drops.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar