CORTICOSTEROIDS AND BACTERIAL CORNEAL ULCERS

Topical corticosteroids should not be part of the initial treatment of bacterial corneal ulcers, according to a study presented at the 2015 European Society of Ophthalmology (SOE) meeting in Vienna.

"It is preferable not to use corticosteroids until the infecting organism has been culture-identified, otherwise we risk doing more harm than good," said Professor Joseph Frucht-Pery of Hadassah University Hospital,  Jerusalem, Israel.

For infection involving the visual axis, Prof. Frucht-Pery said that corticosteroids can be used at least two to three days after improvement with topical antibiotics and, again, preferably after identification of the pathogen. In cases of peripheral ulcers. steroids should be used only occasionally, he added.

Because of the risks associated with their misuse, topical corticosteroids should not be used by general ophthalmologists in community clinics, advised Prof. Frucht-Pery. "These cases should be referred and treated in hospital clinics or by cornea experts," he said.