In ophthalmology, there are multiple diseases or conditions that are caused by inflammation, such as uveitis, allergic conjunctivitis or involvement of the cornea in herpes zoster infection. These inflammatory conditions can be treated with a corticosteroid eye drop such as prednisolone sodium phosphate, which comes on two concentrations: 1/8 percent and 1 percent. These eye drops can also be used after eye surgery such as cataract extraction. While prednisolone eye drops can be very effective in managing certain eye conditions, there are side effects that can occur during its use---these need to be monitored by the eye doctor.
Glaucoma
The eye drop prednisolone can cause an increase in eye pressure, which can lead to the development of glaucoma with optic nerve damage and visual field defects. As noted by R. Rand Allingham and colleagues in the 2004 textbook "Shield's Book of Glaucoma," the eye pressure typically returns to normal after discontinuing the medication. However, the damage may be permanent if the eye pressure was elevated for a long period of time. Because of this, a patient using prednisolone eye drops should have the eye pressure checked regularly by an eye doctor. Also, using prednisolone drops in patients with glaucoma or with a family history of glaucoma should be done with caution.
Cataract Formation
Topical use of prednisolone eye drops can also cause cataract formation. According to the National Library of Medicine's DailyMed website, this is usually a specific type of cataract called a posterior subcapular cataract; this forms at the back of the natural lens of the eye and can cause problems with glare and visual acuity. However, discontinuing the eye drop will not cause the cataract to disappear. Once a cataract forms and is interfering with visual acuity, the only solution is cataract extraction surgery.
Ocular Infections
An eye infection may become worse during the use of prednisolone eye drops. When an eye doctor prescribes a corticosteroid drop, there must be a thorough examination to ensure that there is no underlying infection in the eye. According to Michael J. Doughty in the 2001 textbook "Ocular Pharmacology and Therapeutics: a Primary Care Guide," an eye doctor must also make sure that there are no signs of herpes simplex infection because prednisolone could make the condition worse and spread it further into the eye. Fungal infections may also worsen during prednisolone treatment.
Delayed Wound Healing
The use of prednisolone eye drops can impair wound healing. As noted in the 2007 textbook "Uveitis and Immunological Disorders" by Uwe Pleyer and C. Stephen Foster, the changes in healing may be related to reduced collagen and inhibition of other cells important in repair. Since corticosteroid eye drops may be used after cataract surgery or corneal transplantation, this fact is important for eye doctors to consider when prescribing.
Perforation of the Globe
According to the National Library of Medicine's DailyMed website, the use of prednisolone eye drops may cause the formation of a hole or perforation of the globe; this may occur in certain diseases that involve thinning of the cornea or the sclera. In these conditions, the eye doctor must evaluate the use of prednisolone drops and weigh the benefits and risks.
References
- "Shields' Textbook of Glaucoma"; R.R. Allingham, M.B. Shields, S. Freedman; 2004
- National Library of Medicine DailyMed: Prednisolone Sodium Phosphate
- "Uveitis and Immunological Disorders"; U. Pleyer, C.S. Foster; 2007
- "Essentials of Ophthalmology"; N.J. Friedman, P.K. Kaiser; 2007
- "Ocular Pharmacology and Therapeutics: A Primary Care Guide"; M.J. Doughty; 2001
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