Risks of topical ocular antibiotics and corticosteroids

The use of corticosteroids in ophthalmology was first introduced in the 1950s by Gordon and McLean¹. Corticosteroids exert their anti-inflammatory effects via the inhibition of arachidonic acid and its eicosanoids (prostacyclins, prostaglandins, thromboxanes and leukotrienes). Topical corticosteroids play a paramount role in the management of a variety of inflammatory ocular conditions including uncomplicated anterior uveitis, control of post-surgical inflammation, prophylaxis and corneal allograft rejection treatment, stromal and endothelial herpes simplex keratitis, as per the Herpetic Eye Disease Study (HEDS), and occasionally aspects of keratoconjunctivitis sicca¹.