Steroid Use for Conjunctivitis: Risks and Recommendations

Q: Steroid Use for Conjunctivitis: Risks and Recommendations

Hello XUAN： <br>1. <br>If I continue using steroid eye drops, will it cause any harm? (Steroids seem to increase intraocular pressure, raise the risk of cataracts, and impair vision.) <br>Answer： The risk is actually not very high; if the condition requires it, there is no need t

Steroid conjunctivitis

Hello Doctor, I was diagnosed with conjunctivitis last week.
After a week of treatment, my eyes are no longer red, swollen, or painful, but the inner corners of my eyes still feel itchy.
However, since I have allergies, I'm unsure if the itching is due to the conjunctivitis or my allergies.
My follow-up appointment is this Friday.

1.
If I continue using the steroid eye drops, could it cause any harm? (I understand that steroids can lead to increased intraocular pressure, a higher risk of cataracts, and blurred vision.)
2.
Is there a risk of developing drug dependence or resistance?
3.
I was originally instructed to use the drops twice a day; can I reduce it to just before bedtime?
4.
The inner corners of my eyes sometimes still feel prickly; does this mean the conjunctivitis hasn't completely resolved?

XUAN, 20~29 year old female. Ask Date: 2019/06/10

Dr. Gao Pilin reply Ophthalmology

Hello XUAN:
1.
If I continue using steroid eye drops, will it cause any harm? (Steroids seem to increase intraocular pressure, raise the risk of cataracts, and impair vision.)
Answer: The risk is actually not very high; if the condition requires it, there is no need to avoid it.
2.
Will it cause drug dependence or resistance?
Answer: No, it will not.
3.
I was originally using it twice a day; can I reduce it to just before bedtime?
Answer: Twice a day is already quite infrequent; there is no need to reduce it.
4.
Sometimes I still feel a stinging sensation in the inner corner of my eye; does this mean the conjunctivitis is not completely healed?
Answer: It is likely not fully healed; please continue using the medication until your follow-up appointment.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, Friday from 8:00 AM to 12:00 PM; Wednesday from 2:00 PM to 4:30 PM.
Online responses are for reference only; if necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.

Gao Pilin

Reply Date: 2019/06/10

More Info

When it comes to the use of steroids for conjunctivitis, there are several important considerations to keep in mind. Conjunctivitis, commonly known as pink eye, can be caused by various factors, including allergies, bacterial infections, and viral infections. The treatment approach often depends on the underlying cause. In your case, since you have a history of allergies, it's essential to differentiate whether your symptoms are due to residual effects of conjunctivitis or an allergic reaction.

1. Risks of Continued Steroid Use: Using steroid eye drops can indeed lead to several potential complications. Prolonged use of corticosteroids can increase intraocular pressure, which may lead to glaucoma. Additionally, long-term steroid use is associated with an increased risk of cataracts, which can affect vision clarity. While steroids can effectively reduce inflammation and provide relief from symptoms, they should be used cautiously and typically for a limited duration. If your symptoms have improved significantly, it may be wise to discuss tapering off the steroid drops with your doctor.

2. Dependency and Resistance: The concern about dependency on steroid eye drops is valid. Patients may find that they need to use the drops more frequently to achieve the same level of symptom relief, which can lead to a cycle of increased use. However, the concept of "antibiotic resistance" does not apply to steroids in the same way it does to antibiotics. Steroids do not cause resistance but can lead to rebound inflammation if discontinued abruptly after prolonged use.

3. Adjusting Dosage: If your symptoms are improving, it may be appropriate to reduce the frequency of steroid drops. However, any changes to your medication regimen should be made in consultation with your healthcare provider. They can provide guidance on how to taper the medication safely. Reducing to once daily or only at bedtime may be acceptable, but this should be confirmed with your doctor.

4. Ongoing Symptoms: The persistent itching or "stinging" sensation in the inner corner of your eye could indicate that the conjunctivitis has not fully resolved, or it may be a sign of an allergic reaction. Allergies can cause similar symptoms, and if you have a history of allergic conjunctivitis, it’s possible that your symptoms are related to that. It’s essential to monitor your symptoms and report any ongoing issues to your doctor during your follow-up appointment.

In summary, while steroid eye drops can be effective for treating inflammation associated with conjunctivitis, they come with risks that necessitate careful management. It's crucial to communicate openly with your healthcare provider about your symptoms and any concerns you have regarding your treatment. They can help you navigate the best course of action, whether that involves continuing, tapering, or switching medications based on your specific situation. Always prioritize follow-up appointments to ensure your eye health is being monitored appropriately.

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