May 15, 2008

THE EYE MAN: What's the deal with steroids?

By Andrew Soss / Daily News Columnist

Dr. Soss,

I have had this weird condition with my eyes for about two to three weeks now. What happened was that my vision started to get real blurry. So, I went to my eye doctor who said that I have an atopic keratitis (I had him write it down so that I wouldn't forget). Anyhow, he has me on this steroid eyedrop that doesn't seem to be doing a lot. He tells me to keep taking it. But, I read online that steroids are bad for you. What should I do? Should I keep taking the drop, or what do you think?

S.G.



S.G.,

An atopic keratitis is a condition in individuals who tend to have nonspecific allergy-like or inflammatory-like skin conditions such as eczema. There can be an acute onset in the cornea of the eye, which becomes inflamed. As a result, there is often a sudden onset of reduced vision, which brings the patient into our office. This condition is not painful, but is annoyingly uncomfortable. However, it is the decline of vision that is the most problematic portion of this condition.

We don't always know what brings on this type of keratitis. But, again, most of these susceptible individuals have a similar background. We tend to see this more often during the spring, in individuals who wear contact lenses, persons with a lot of allergies or skin conditions such as eczema, or in high stress related conditions.

The proper treatment is corticosteroid eyedrops. Depending upon the severity of the condition, I may have a patient use these drops up to three times per day. As the condition improves, I will taper the medication to two times per day, then to one time per day, and so forth. Yes, there are many times I will have patients taking drops from two weeks up to six weeks with this form of keratitis. But it is important to both explain to the patient the possible estimated time this condition may last as well as to follow the patient for potential side effects associated with corticosteroid therapy.

Treatment is very successful. But patients need to be very patient due to the relatively long therapy time. It is important to understand that while most eye infections conclude their treatment within 10 days to two weeks; this treatment is usually significantly longer. So, be patient. Everything should go back to normal shortly.



Questions to Dr. Soss should be sent to his e-mail theeyedoctor@att.net or via his Web site at www.dr-andrewsoss.com. All answers & opinions are those of Dr. Soss and not necessarily shared, endorsed or affiliated with this or any of our newspaper agencies.

Dr. Andrew C. Soss OD, FAAO has been practicing for over 20 years. During that time he has been a clinical instructor in the department of ocular pathology at the University of California. As a primary eye care provider in private practice in Burlingame, he is also board certified in the diagnosis, treatment, and management of primary open angle glaucoma.