ANSWER BACK: Should I give ocular steroids just in case?(Brief Article)

Q: I have had two patients, one with (unexplained) uveitis and one with severe allergic conjunctivitis. Both have been given steroids in the past and want to have scripts `just in case' when they travel. I have been reluctant to prescribe.

A: One of the `rules' of ophthalmology is patients should not have ocular steroids unless they have been examined and can be followed up with slit lamp examination. This is because the diagnosis may have changed - for example, instead of idiopathic uveitis they have developed a herpes simplex keratitis - and because even in the short- term topical steroids can cause side-effects such as raised intraocular pressure (IOP).

Although fluoromethalone has a slightly lower propensity to raise the IOP, in reality it has the same adverse effect profile as the other steroids, so it is better to regard all of them with caution.

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