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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
In a group of 203 patients with eyelid dermatitis, one reacted to fluorometholone (test concentration and vehicle not mentioned); the relevance was not specified and it is unknown how many individuals were tested with this material (2).
Allergic Diseases of the Eye
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
For patients presenting with acute symptoms, it is usual to prescribe a moderately potent topical steroid with low ocular penetration, such as fluorometholone or loteprednol, three or four times a day for around two weeks. Along with this a mast cell stabilizer or a dual action drug is started as a preventive medication, intended for long term instillation (Mantelli et al. 2007). Prophylactic treatment is usually continued through the expected period of allergen exposure. As drugs such as olopatadine and alcaftadine are available as once-a-day preparations for this purpose, compliance is usually good.
Special Cases in the Diagnosis and Treatment of Fungal Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
The following principles are based on our regular practices. Local use of steroid eye drops, like 0.02% fluorometholone eye drops, is started twice a day. Changes of eye congestion and anterior chamber inflammation, particularly signs of recurrence, are closely monitored. If no infection recurs, and photophobia and congestion are relieved, 0.02% fluorometholone eye drops are adjusted to four times daily after 2 to 3 days. If there is still no recurrence, dexamethasone eye ointments are given at night. After confirmation of no recurrence with local medication, 40 mg of oral prednisone is administered for prevention of immune rejection.
Practical use and prescription of ocular medications in children and infants
Published in Clinical and Experimental Optometry, 2021
Ann L Webber, Phillipa Sharwood
Severe acute flares or recalcitrant chronic disease may require the use of topical steroids. Fluorometholone, e.g. FML or Flarex, provides ocular surface anti-inflammatory action with reduced intraocular penetration so it is less likely to lead to an IOP rise or cataract formation than more potent steroids such as dexamethasone or prednisolone. This is usually commenced at 2–3x day instillation and then weaned over a couple of weeks as symptoms improve. Topical hydrocortisone ointment (Hycor 1%) is useful to instil at night-time while asleep in children who are resistant to eye drop instillation or to apply for a short period to the eyelids in children with associated periocular eczema. Although hydrocortisone 1% is a mild steroid, the ointment form has prolonged contact with the eye and more intraocular penetration, thus has a higher risk of intraocular pressure rise.
Optical quality in patients with dry eye before and after treatment
Published in Clinical and Experimental Optometry, 2021
Yufei Gao, Rongjun Liu, Yiyun Liu, Baikai Ma, Tingting Yang, Chenxi Hu, Hong Qi
In this study, patients were treated with fluorometholone eye drops, a type of steroid, for two-weeks. We speculate that if the patients only received artificial tears without steroids, the corneal fluorescein staining score would not have improved to such a notable degree. Steroids have considerable anti‐inflammatory effects, which could aid in corneal fluorescein staining improvement. According to our result that changes in standard deviation of corneal power and in surface asymmetry index were well correlated with change in corneal fluorescein staining, we could also speculate that optical quality would accordingly not have improved to such a marked degree. The usage of steroidal eye drops partly depended on the severity of corneal fluorescein staining. If the corneal fluorescein staining score improved to 0–3 after the two‐week treatment, we would consider continuing the artificial tear administration without the steroid eye drops.
Corneal melting in a case undergoing treatment with pembrolizumab
Published in Clinical and Experimental Optometry, 2020
Chang‐chi Weng, Chih‐chiau Wu, Pei‐yu Lin
The use of topical corticosteroids in corneal melting is controversial. Because the ocular immune‐related adverse events are often accompanied with systemic side effects, patients were often also treated with systemic corticosteroids.2018 It is hard to tell the effect of topical corticosteroids alone in the treatment of corneal immune‐related adverse events. Slow response to topical corticosteroid was reported by Hsiao et al.2018 in patients with corneal epithelial sloughing induced by pembrolizumab after allogeneic peripheral blood stem cell transplantation. The rationale of using low‐potency steroids 0.02% fluorometholone was to suppress ocular surface inflammation and hopefully with minimal inhibitory effect on corneal wound healing. Although the treatment regimen in our patient was effective, carefully monitoring surface response is mandatory if combining topical corticosteroids in cases with corneal melting.