the Risks of Long-Term Steroid Eye Drops for Dry Eyes

Q: the Risks of Long-Term Steroid Eye Drops for Dry Eyes

Hello： 1. <br>Is using steroid eye drops for over two months considered long-term use as mentioned online? According to general medical perspectives, long-term use of steroid eye drops typically refers to continuous use for more than six months. <br>Therefore, your current durati

Usage of Eye Drops for Dry Eye Syndrome

Hello, doctor.
Due to my dry eye syndrome, I have seen an ophthalmologist nearly ten times since April 23rd and have been using eye drops for over two months now, including artificial tears and anti-inflammatory eye drops.
I later learned that these anti-inflammatory eye drops contain steroids (such as Lotemax and Pred Forte).
After researching online, I found that long-term use of steroid eye drops may increase the risk of glaucoma.
I would like to ask you:
1.
I have been using these steroid-containing eye drops for over two months.
Does this qualify as long-term use as mentioned online?
2.
A few days ago, I visited the outpatient clinic again and received more steroid-containing eye drops, which I plan to continue using until my follow-up appointment in early August.
If this is considered long-term use, should I continue using the eye drops? (By the way, none of the ophthalmologists I have seen mentioned my intraocular pressure.)
3.
The outpatient doctor advised me to apply warm compresses to my eyes daily.
I usually do this before bed, but I also need to use Vitis eye gel before sleeping.
How long after applying the warm compress should I wait before using the gel?
4.
On a related note, my myopia is nearly 500 degrees in both eyes, with astigmatism over 100 degrees in each eye.
Does this qualify as high myopia as mentioned online?
Thank you for taking the time to respond, and I appreciate your help!

Liu Xiansheng, 20~29 year old female. Ask Date: 2023/07/09

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Is using steroid eye drops for over two months considered long-term use as mentioned online? According to general medical perspectives, long-term use of steroid eye drops typically refers to continuous use for more than six months.
Therefore, your current duration of using steroid eye drops has not yet reached the standard for long-term use.
However, individual responses to medication can vary, so if you have any concerns, it is best to discuss them with your ophthalmologist.
2.
If your doctor recommends that you continue using steroid eye drops until your follow-up appointment in early August, should you continue using the eye drops? This question is best discussed with your ophthalmologist, as they are most familiar with your condition.
If you have concerns or questions, it is advisable to communicate with your doctor and ask them to explain why continued use of steroid eye drops is necessary, as well as provide detailed information regarding the risks and benefits.
3.
How long should you wait after applying a warm compress to your eyes before using eye gel? Applying a warm compress can help alleviate dry eye symptoms, and it is generally recommended to wait about 10 to 15 minutes after the compress to allow your eyes to cool down before using eye gel.
4.
Do you have high myopia? Based on the prescription you provided, with myopia in both eyes ranging from 400 to 500 degrees and astigmatism around 100 degrees, this can be classified as moderate to high myopia.
However, there are different standards for classifying myopia, so it is advisable to have your retina examined by a doctor to determine your specific condition.

Reply Date: 2023/07/09

More Info

When it comes to the long-term use of steroid eye drops for dry eyes, it's essential to understand both the benefits and potential risks associated with these medications. Steroid eye drops, such as those you've mentioned (e.g., Lotemax, Pred Forte), are often prescribed to reduce inflammation and provide relief from symptoms associated with dry eye disease. However, their long-term use can lead to significant side effects, including increased intraocular pressure (IOP) and the potential development of glaucoma.

1. Duration of Use: You mentioned that you have been using steroid eye drops for over two months. While "long-term" can vary depending on the context, many healthcare professionals consider the use of steroid eye drops for more than a few weeks as potentially long-term. The risk of developing complications, such as elevated IOP, increases with prolonged use. Therefore, it is crucial to have your eye pressure monitored regularly, especially if you are using these drops continuously.

2. Continuation of Use: If your ophthalmologist has prescribed these drops and has not expressed concern regarding your eye pressure, it may be appropriate to continue their use. However, it is vital to communicate any concerns you have about potential side effects. If you are experiencing any symptoms such as blurred vision, halos around lights, or eye pain, you should inform your doctor immediately. Regular follow-ups are essential to monitor your eye health and adjust your treatment plan as necessary.

3. Heat Compress and Gel Application: Regarding the use of heat compresses and eye gels, it is generally recommended to wait about 10-15 minutes after applying a warm compress before using any eye gel or ointment. This allows the heat to open up the meibomian glands and improve oil secretion, which can enhance the effectiveness of the artificial tears or gels you apply afterward. Applying the gel too soon after heat treatment may wash away the benefits of the compress.

4. Myopia Assessment: As for your refractive error, a prescription of -4.00 to -5.00 diopters for myopia (nearsightedness) and -1.00 for astigmatism does classify you as having moderate myopia. High myopia is typically defined as a refractive error greater than -6.00 diopters. However, the classification can vary slightly among professionals, and the impact of myopia on your overall eye health is more critical than the specific classification. Regular eye exams are essential to monitor for any complications associated with myopia, such as retinal detachment or macular degeneration.

In summary, while steroid eye drops can be effective in managing dry eye symptoms, their long-term use requires careful monitoring due to the risk of increased intraocular pressure and potential glaucoma. Regular communication with your ophthalmologist about your treatment plan and any side effects you experience is crucial. Additionally, maintaining a routine that includes heat compresses and appropriate timing for gel application can help manage your dry eye symptoms effectively. Always prioritize your eye health by adhering to follow-up appointments and discussing any concerns with your healthcare provider.

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