Which medications in the drug class Corticosteroids are used in the treatment of Viral Conjunctivitis (Pink Eye)?

Updated: Mar 24, 2020
  • Author: Ingrid U Scott, MD, MPH; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Corticosteroids

Corticosteroids may be used for pseudomembranes and decreased vision and/or glare due to subepithelial infiltrates. They have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli. Extreme caution should be taken when using corticosteroids, as they may worsen an underlying HSV infection or induce dependency in the context of persistent EKC subepithelial infiltrates.

Prednisolone ophthalmic (AK-Pred, Pred Mild, Omnipred)

This agent decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability. Less potent (eg, prednisolone 0.125%, fluorometholone 0.1%) are usually sufficient to treat subepithelial infiltrates. The steroid must be tapered very carefully, often over months. Topical cyclosporine A emulsion (Restasis, Allergan, Irvine CA) may provide a viable steroid-sparing alternative for selected patients.

Fluorometholone (Flarex, FML, FML Forte)

Fluorometholone inhibits edema, fibrin deposition, capillary dilation, phagocytic migration, capillary proliferation, collagen deposition, and scar formation. It decreases inflammation and corneal neovascularization, suppresses migration of PMNs, and reverses capillary permeability. It is believed to act by inducing phospholipase A2 inhibitory proteins.

Loteprednol ophthalmic (Alrex, Lotemax)

Loteprednol etabonate decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reversing increased capillary permeability.


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