Topical steroid and antibiotic combination therapy in red eye conditions

摘要

The ‘acute red eye’ is a common ophthalmic presentation to primary health care. The majority of cases can safely and successfully be treated in the community. With the advent of combination preparations containing topical steroid and antibiotic such as Betnesol N® (betamethasone and neomycin) and Maxitrol® (dexamethasone and neomycin) there appear to be some who favour this ‘blanket’ treatment. Unfortunately, in doing so these patients run the small, but potentially devastating, risk of exacerbation of latent herpetic infection, secondary infection and increased intraocular pressures, the latter which may go unmonitored. While it is true that the majority of these patients who have been treated for red eye with these drops come to no harm, there are many potential pitfalls associated with this management strategy. Occasionally we encounter a few nasty and preventable surprises in patients presenting to an eye clinic with a history of topical steroid-antibiotic combination treatment for red eye of uncertain aetiology.