Topical Ophthalmic Corticosteroid Pregnancy: Compatible for short-term ophthalmic use — negligible systemic absorption

Prednisolone Eye Drops

Brand names: Pred Forte (1%), Predsol (0.5%)

Adult dose

Dose: Post-surgical inflammation: 1 drop QDS (decreasing to OD over 4 weeks). Anterior uveitis: 1 drop hourly in acute phase, tapering to QDS then less.

Route: Topical ophthalmic

Frequency: QDS–hourly (acute); tapering schedule

Max: 1 drop per dose; frequency determined by indication

For anterior uveitis, post-operative inflammation, corneal graft rejection, severe allergic eye disease. Must taper slowly — abrupt withdrawal causes rebound inflammation.

Paediatric dose

Route: Ophthalmic

Frequency: QDS

Max: 1 drop QDS

Concentration: 0.5% or 1% solution drop/ml

Paediatric uveitis: specialist ophthalmology protocols. Monitor IOP closely in children (corticosteroid glaucoma risk).

Dose adjustments

Renal

N/A (topical)

Hepatic

N/A

Clinical pearls

IOP monitoring mandatory if using for >2 weeks — steroid-induced glaucoma can be irreversible
Herpes simplex: steroid alone will worsen dendrite — always use with antiviral (aciclovir eye ointment) if HSV suspected
'Red eye': never give topical steroid without ophthalmological assessment — can catastrophically worsen herpes keratitis, microbial keratitis, fungal keratitis

Contraindications

Herpes simplex keratitis (can worsen — dendritic ulcer)
Bacterial infection without antibiotic cover
Fungal keratitis
Perforated globe

Side effects

Raised IOP (steroid-induced ocular hypertension — check IOP if used >2 weeks)
Posterior subcapsular cataract (prolonged use)
Delayed wound healing
Herpes simplex reactivation

Interactions

Systemic corticosteroids — additive adrenal suppression (usually minimal with topical ophthalmic doses)

Monitoring

IOP (>2 weeks use)
Corneal clarity
Vision

Reference: BNFc; BNF; RCOphth Uveitis Guidelines; NICE Uveitis Pathway. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways