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Topical Ophthalmic Medication Guide: Steroids and NSAIDs

Here is a complete list of commonly used ophthalmic medication, Corticosteroids and NSAIDs for you to print out or keep handy.

The last two ophthalmic medication (artificial tears and glaucoma medication) guides published by NGO have been received with such wonderful feedback that we’ve decided to bring you more. Over the coming months, we will provide ophthalmic medication guides covering allergy medications, and antibiotic drops.

Inflammation is one of the most common ocular conditions our patients present with each day. Whether it is a post-op patient trying to prevent complication, a corneal ulcer, conjunctivitis, or chronic dry eye, anti-inflammatory medications play a role in the treatment of an array of diagnoses. Familiarity with the ophthalmic medication options available will make your clinical decision making much easier.

Included below are tables consolidating both the ophthalmic medication corticosteroids and NSAIDs available for topical ophthalmic use.

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About Patricia Fulmer O.D.

Patricia Fulmer O.D.
Patricia is a 2012 graduate of The University of Alabama at Birmingham School of Optometry and former AOSA National Liaison to the AAO. After graduation, she moved to Amarillo, TX, to complete her residency in Ocular Disease and Primary Care at the Thomas E. Creek VA Hospital. Patricia is the current Center Director for VisionAmerica of Huntsville, a co-management practice specializing in secondary and tertiary care, cataract surgery, strabismus, and oculoplastics in Huntsville, AL. She recently earned her Fellowship in the American Academy of Optometry at the 2015 meeting in New Orleans. In her free time, she enjoys traveling, attending concerts, art, and Alabama football.

3 comments

  1. Matt Geller

    @Patricia – Do you have any good resources regarding steroid softness? For example, Lotemax at one end of the spectrum vs. Durezol at the other?

    • Patricia Fulmer O.D.

      Hey @MatthewGeller – it’s difficult to find journals or charts that compare our steroid options based upon their “softness” specifically. However, since what makes a steroid soft is it’s decrease in side effects and increase in safety, you can find some that compare those characteristics. Drs. Melton and Thomas (Review of Optometry, Clinical Guide to Ophthalmic Drugs, May 2014) mention the increased risk of side effects with Durezol and the significantly lower rate of IOP spikes with Lotemax, thus establishing Lotemax as the softer steroid. Review of Cornea and Contact Lenses featured an article in March 2011 by Drs. Bowling and Russell (Topical Steroids and the Treatment of Dry Eye) in which they also mention FML and Lotemax causing less side effects than Pred or dexamethasone. In addition, Review of Optometry has a CE lesson released in 2011 called “Steroids: Use with Caution and with Confidence” by Dr. William Potter that establishes FML and Lotemax as softer steroids than Durezol, Pred, and dexamethasone. Overall, Durezol’s increased potency (which has been well-documented) can result in more frequent and marked side effects than the other options, which makes it the least soft of the ophthalmic steroids. Sorry I can’t provide resources that exactly answer your question, but I hope this info helps!

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