Modern corneal refractive therapies

The AOA’s CLCS Newsletter, January 2013

Back to the Basics: The Latest on Steroid Medications
Stephanie L. Woo, O.D.

Topical ophthalmic steroids are categorized as synthetic glucocorticoids,
meaning that they are manufactured to mimic the effects of their naturally
occurring counterpart known as cortisol.1 Steroids are used to help control
inflammation and scarring; however, risk factors include problems such as
glaucoma, cataracts and the potential for infection, especially when using
steroids for a longer period of time.2,3 Here we review some of the most
common ocular topical steroids and their uses.
Soft Steroids: soft steroids can decrease inflammation, yet allow longer tapering schedules.
They are usually considered safer than the stronger steroids and have milder
immunosuppression and fewer side effects.1
 Alrex (loteprednol 0.2 percent, Bausch + Lomb): Indicated for seasonal allergic  Lotemax (loteprednol 0.5 percent, Bausch + Lomb): Indicated for post-operative inflammation following cataract surgery, acute anterior uveitis, giant papillary conjunctivitis, and seasonal allergic conjunctivitis.4  FML (flouromethalone alcohol 0.1 percent, Allergan): Indicated for the treatment of corticosteroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.5 *Alrex is available in an ophthalmic suspension, while Lotemax and FML are available in ophthalmic suspensions or ointments. Stronger Steroids: these steroids are indicated for acute and severe inflammation and are usually intended for short-term usage.  Pred Forte (prednisolone acetate 1 percent, Allergan): Indicated for the treatment of steroid- responsive inflammation of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe.6  Durezol (difluprednate 0.05 percent, Alcon): Indicated for the treatment of inflammation and pain associated with ocular surgery and the treatment of endogenous anterior uveitis.7  Dexamethasone (dexamethasone 0.1 percent): Indicated for allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitide, and other ocular inflammation.8  *Durezol is available in an ophthalmic emulsion, while Pred Forte and Dexamethasone are available in ophthalmic suspensions and ointments. Pred Forte and Dexamethasone are also available in antibiotic and anti-inflammatory combination suspensions or ointments. Abelson M, et al. Insights on anti-inflammatories. Rev Ophthalmol. 2005 June; 12(6):80-4. Jaanus SD, et al. Anti-inflammatory drugs. Clinical Ocular Pharmacology, 4th ed. Boston: Butterworth, 2001:273-276. Armaly MF, Becker B. Intraocular pressure response to topical corticosteroids. Fed Proc. 1965 Nov-Dec;24(6):1274-8. Food and Drug Administration. Determination of Regulatory Review Period for Purposes of Lotemax and Alrex. Daily Med. Fluoromethalone Emulsion. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6ae122c0-eb4f-4124-96d7-ba5e9a350d35 6/2012. Daily Med. Pred Forte. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=00a5aa88-e361-4ea7-8922-530c738b726e. 1/2012. Daily Med. Durezol Emulsion. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d07b65d5-f8e3-4594-a7fb-108218746cec. 1/2012. The AOA’s CLCS Newsletter, January 2013
Daily Med. Dexamethasone suspension.8/2011.
Dr. Woo graduated from the Southern California College of Optometry. She completed a
Cornea and Contact Lens residency at the University of Missouri - St. Louis. She currently
works at Havasu Eye Center in Lake Havasu, Ariz.
Please close this browser window to return to the CLCS Newsletter

Source: http://stage.aoa.org/Documents/optometrists/Newsletters/CLCS%20January%2013%20Newsletter/CLCS1212S3.pdf