From the Guidelines
Dexamethasone eye drops should be dosed at ≤3 drops daily to minimize the risk of cataract formation. According to the study by Constantin et al. 1, the risk of cataract formation increases with the number of drops of topical corticosteroids instilled, and treatment with low doses of topical corticosteroids (≤3 drops daily) over moderate periods of follow-up (median 4 years; range 0.5–15 years) has a low risk of developing cataracts.
Key Considerations
- The study found that among eyes receiving ≤2 drops daily, the incidence of cataract was 0/eye year 1.
- Topical corticosteroids, such as dexamethasone, are the first-line treatments of choice for both acute and chronic anterior uveitis 1.
- Systemic corticosteroids are not usually preferred in children due to risks of growth suppression and osteopenia, but may be helpful in individual cases for rapid control of severe uveitis or in the presence of macular oedema 1.
Administration and Monitoring
- Patients should be instructed on proper administration techniques to minimize systemic absorption and maximize local effect.
- Regular monitoring by an eye care professional is necessary to watch for potential side effects, such as increased intraocular pressure, cataract formation, and increased susceptibility to ocular infections.
- Treatment courses should be tapered rather than stopped abruptly to prevent rebound inflammation, especially after prolonged use.
From the Research
Dosing Recommendation for Dexamethasone Eye Drops
- The dosing recommendation for dexamethasone eye drops is not explicitly stated in the provided studies, but the concentration of dexamethasone used in the studies is 0.1% 2, 3.
- In the study by 3, patients received topical dexamethasone 0.1%/povidone-iodine 0.4% eye drops four times daily for seven days.
- Another study 2 compared the efficacy of dexamethasone Na phosphate 0.1% with other topical steroids for acute anterior uveitis, but it does not provide information on the dosing frequency.
- The studies suggest that the dosage and frequency of dexamethasone eye drops may vary depending on the specific condition being treated and the clinical judgment of the physician 4, 5, 6.
Concentration of Dexamethasone
- The concentration of dexamethasone used in the studies is 0.1% 2, 3.
- This concentration is used in combination with other ingredients, such as povidone-iodine 0.4% 3, or as a solo ingredient 2.