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Topical Ophthalmic Corticosteroid Pregnancy: §4.6, verbatim: 'There is inadequate evidence of safety in human pregnancy. Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate and intra-uterine growth retardation. There may therefore be a very small risk of such defects in the human foetus. Therefore this product should be used with caution during pregnancy only if the potential benefit outweighs the potential risk to the foetus.' Breast-feeding: 'It is not known whether topical administration of Pred Forte could result in sufficient systemic absorption to produce detectable quantities in breast milk. Therefore, use is not recommended in women breast-feeding infants.'

Prednisolone Eye Drops

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

Prednisolone eye drops are a topical corticosteroid used to treat ocular inflammation, including anterior uveitis and postoperative or non-infective inflammatory conditions of the eye.

Adult dose

Dose: SCOPE — THESE FIGURES ARE FOR THE 1% w/v PRODUCT ONLY: 'Pred Forte 1% w/v, Eye Drops Suspension'. The other product this page names in its own brand list, Predsol (0.5%), is a different strength with its own separate SPC, which is NOT in this bundle; its regimen must not be assumed to match and nothing here may be applied to it. Adults — §4.2 verbatim: 'One to two drops instilled into the conjunctival sac two to four times daily. During the initial 24 to 48 hours the dosing frequency may be safely increased to 2 drops every hour. Care should be taken not to discontinue therapy prematurely.' Elderly — §4.2 verbatim: 'No overall differences in safety or effectiveness have been observed between elderly and younger patients.' The fetched §4.2 does not restate the indication (§4.1 was not retrieved), so this is the product's adult ocular posology rather than an indication-specific regimen.
Route: Topical ophthalmic — instillation into the conjunctival sac of the affected eye. §4.2 verbatim: 'Route of administration is by ocular instillation. To reduce possible systemic absorption, it may be recommended that the lacrimal sac be compressed at the medial canthus (punctal occlusion) for 1 minute. This should be performed immediately following the instillation of each drop. Shake well before use.' §4.4: 'To prevent eye injury or contamination, care should be taken to avoid touching the bottle tip to the eye or to any other surface.'
Frequency: Two to four times daily; during the initial 24 to 48 hours the frequency may be increased to 2 drops every hour. Therapy should not be discontinued prematurely.
Max: 2 drops every hour, and only during the initial 24 to 48 hours — §4.2 verbatim: 'During the initial 24 to 48 hours the dosing frequency may be safely increased to 2 drops every hour.' No higher frequency or drop count appears anywhere in the fetched SPC. §4.4 adds a DURATION limit rather than a dose ceiling, verbatim: 'Eye drops containing corticosteroids should not be used for more than 10 days except under strict ophthalmic supervision with regular checks for intraocular pressure.'
It does NOT cover the whole page: the page's own brand list names two products at two strengths (Pred Forte 1% and Predsol 0.5%) and only the 1% SPC was fetched, which is why the scope statement is carried inside the dose text itself. §4.4 excipient warning relevant at the point of administration: 'The preservative in Pred Forte, benzalkonium chloride, may be absorbed by and cause discoloration of soft contact lenses. Patients wearing soft contact lenses should be instructed to remove contact lenses prior to administration of the solution and wait at least 15 minutes after instilling Pred Forte before reinserting soft contact lenses.' §4.4 also warns that 'Pred Forte contains no antimicrobial agent. If infection is present, appropriate measures must be taken to counteract the infective organisms.'

Paediatric dose

NO PAEDIATRIC DOSE EXISTS IN THE FETCHED LABEL. §4.2 'Paediatric population', verbatim and complete: 'The safety and efficacy in paediatric population have not yet been established. No posology can be recommended.' §4.4 adds a specific paediatric caution: 'The possibility of adrenal suppression should be considered with prolonged, frequent, use of high dose topical steroids, particularly in infants and children.' dosePerKg is deliberately null — this is a topical drop regimen, never a per-kilogram dose. Verify any paediatric use against a current children's formulary and specialist ophthalmic advice.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • §4.3, verbatim: 'Acute untreated purulent ocular infections.'
  • §4.3, verbatim: 'Acute superficial herpes simplex (dendritic keratitis); vaccinia, varicella and most other viral diseases of the cornea and conjunctiva.'
  • §4.3, verbatim: 'Fungal diseases of the eye.'
  • §4.3, verbatim: 'Mycobacterial infection such as tuberculosis of the eye.'
  • §4.3, verbatim: 'Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.'
  • Not contraindications but §4.4 cautions: use in the presence of thin corneal or scleral tissue 'may lead to perforation'; steroids 'should be used with caution in the presence of glaucoma'; 'Use of steroid medication in the presence of stromal herpes simplex requires caution and should be followed by frequent, mandatory, slit-lamp microscopy.'

Side effects

  • §4.8 lists all reactions with frequency 'Not known (cannot be estimated from available data)'.
  • Eye disorders: intraocular pressure increased; cataract (including subcapsular); eye penetration (scleral or corneal perforation); foreign body sensation; ocular infection (including bacterial, fungal and viral infections); ocular stinging; eye irritation; eye pain; ocular hyperaemia; vision blurred / visual impairment; mydriasis; eyelid ptosis.
  • Immune system disorders: hypersensitivity, urticaria. Nervous system disorders: headache. Gastrointestinal disorders: dysgeusia. Skin and subcutaneous tissue disorders: pruritus, rash.
  • §4.8, systemic effects, verbatim: 'extensive topical use of corticosteroids may lead to systemic side effects'.
  • §4.4: 'Posterior subcapsular cataract formation has been reported after heavy or protracted use of topical ophthalmic corticosteroids. The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation.'

Monitoring

  • §4.4, intraocular pressure, verbatim: 'Prolonged use of topical corticosteroids may cause an increase in intraocular pressure in certain individuals. This may result in glaucoma with damage to the optic nerve with resultant defects in visual acuity and visual fields… It is advisable that intraocular pressure be checked frequently during treatment with Pred Forte.'
  • §4.4, duration, verbatim: 'Eye drops containing corticosteroids should not be used for more than 10 days except under strict ophthalmic supervision with regular checks for intraocular pressure.'
  • §4.4, herpes simplex, verbatim: 'Use of steroid medication in the presence of stromal herpes simplex requires caution and should be followed by frequent, mandatory, slit-lamp microscopy.'
  • §4.4, infection, verbatim: 'Fungal infections of the cornea have been reported coincidentally with long-term steroid application and fungal invasion may be suspected in any persistent corneal ulceration where a steroid has been used, or is in use.'
  • §4.4, systemic absorption: 'Systemic adverse events may occur with extensive use of topical steroids; punctal occlusion may be recommended.' Consider adrenal suppression with prolonged, frequent, high-dose use, particularly in infants and children.
  • §4.4 was cut at the source-fetch limit inside the 'Visual disturbance' paragraph — monitoring advice beyond that point was never retrieved.

Clinical monograph

How it works

Prednisolone suppresses the inflammatory response by inhibiting multiple inflammatory mediators and reducing capillary permeability and cellular infiltration at the ocular surface and anterior segment.

Prescribing in practice

  • Topical ocular corticosteroids can raise intraocular pressure, promote cataract formation and worsen or mask ocular infection (including herpes simplex keratitis and fungal infection), so they should be used under specialist or appropriately experienced supervision and avoided in undiagnosed red eye.
  • Prolonged use should be tapered rather than stopped abruptly to reduce rebound inflammation.
  • Avoid in active untreated epithelial herpes simplex keratitis and other untreated ocular infections.

Monitoring

Intraocular pressure should be monitored during prolonged use, particularly in patients predisposed to a steroid response or with glaucoma.

Counselling the patient

  • Use exactly as directed and do not stop suddenly without advice.
  • Report any worsening pain, increasing redness or deteriorating vision promptly.
  • Vision may blur briefly after instillation.

Evidence & guidelines

Topical corticosteroids are standard therapy for non-infective anterior segment inflammation, with MHRA and SPC guidance highlighting intraocular pressure and infection risks.

Reference: RCOphth Uveitis Guidelines; NICE Uveitis Pathway; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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