Side effects of prednisolone eye drops after cataract surgery

Prednisolone eye drops are a corticosteroid drug suspension applied to the eyes. Steroids can reduce some types of irritation, swelling, and redness by decreasing inflammation that's mediated by your immune system. It is used when the eyes have been irritated by allergies, irritation, or infection. 

Common brand names of prednisolone include AK-Pred, Econopred, Omnipred, Pred Mild, Inflamase Forte, and Pred Forte. Prednisolone is also used in combination with other ocular medications such as sulfacetamide or neomycin.

Uses 

Prednisolone is approved to treat mild to moderate non-infectious causes of eye irritation, including redness, swelling, and burning caused by chemicals, radiation, heat, allergies, or objects in the eye. Eye irritation due to severe acne and shingles may also warrant the use of prednisolone eye drops.

After surgery, such as a corneal graft transplant surgery, prednisolone is often used to prevent the body from rejecting the graft.

Before Taking

An eye specialist typically prescribes prednisolone for mild to moderate short-term eye irritation. The specialist will check to ensure the cause of your eye irritation is not due to an active bacterial, viral, or fungal infection before prescribing it.

Before taking prednisolone eye drops, be sure you know exactly how to apply them. Ask your healthcare provider for a detailed explanation. 

Precautions and Contraindications

Notify your healthcare provider of any other medications and supplements you take. If you have any allergies, or if you wear contacts, let your healthcare provider know this as well.

If you are or might become pregnant while taking prednisolone eye drops, tell your healthcare provider. Additionally, if you are breastfeeding, you should not take prednisolone.

Be sure to let your healthcare provider know of any conditions you might have, such as:

• Glaucoma
• Cataracts
• Diabetes
• Bacterial, viral, or fungal infections

If you don't have adequate improvement after two days of use, your healthcare provider may re-examine you to determine if you have an underlying condition, such as an infection. After you complete your course of prednisolone eye drops, your healthcare provider will need to examine you before renewing your prescription, if necessary.

Long-term use of corticosteroids can lead to complications such as fungal infections of the cornea and can also lead to cataracts and cause a rise in eye pressure leading to glaucoma.

Other Opthamalic Corticosteroids

There are several other ophthalmic corticosteroid medications.

These include:

• Loteprednol
• Fluocinolone
• Fluorometholone
• Dexamethasone
• Difluprednate
• Triamcinolone
• Medrysone
• Rimexolone 

Dosage

Before taking prednisolone eye drops, be sure to wash your hands thoroughly. Shake the bottle before use if instructed to do so on the label. Inspect the dropper for signs of damage such as cracks, and avoid touching the dropper with your fingers or anything else to prevent contamination.

Follow these instructions for applying the eye drops:

1. Tilt your head back and, with a clean or gloved index finger, pull back your lower eyelid.
2. Hold the dropper tip with your other hand, pointing into the open lid. Look up and drop one drop into the lid. Do not let the dropper tip touch your eye or eyelid.
3. Keep your eye closed for two to three minutes with your face towards the floor. Avoid squeezing your eyes shut or blinking.
4. If you are prescribed more than one drop at a time, wait five to 10 minutes or as instructed by your eye doctor before placing in another drop.
5. Remove excess medication with a tissue or clean, dry cloth.
6. Replace the cap on the dropper and do not rinse or wash it. Wash your hands after applying your eye drops.
7. Repeat as prescribed or as instructed by your eye doctor.
8. Take all of your medication, even if you begin to feel better.

All instructions are according to the drug manufacturer. Check your prescription and talk to your healthcare provider to make sure you are taking the right dose for you.

If you don't experience improvement after two days, tell your healthcare provider. Also, notify your healthcare provider if you still have symptoms after you complete your whole presciption.

How to Take and Store

Follow all of the instructions and make sure your hands are clean before and after use.

If your healthcare provider approves this medication for you while you are using contacts, make sure you take them out before administering the drops and wait 15 minutes or more before putting them back in.

If you miss a dose, do not take a double amount at the same time. Take the missed dose as soon as possible, as long as it isn’t already time for your next dose. Space your doses as prescribed by your eye doctor, usually every two to three hours during the day.

Be sure to read the warning instructions that come with your medication. Prednisolone eye drops are only to be taken in the eyes, not in the mouth or elsewhere. If you or anyone else swallows this medication, drink plenty of water, and call poison control.

The poison control toll-free nationwide number:

1-800-222-1222

Store prednisolone eye drops in its original container, making sure it’s sealed tightly, placed upright, and out of children’s reach. You should avoid storing it in a humid or warm area such as the bathroom. The ideal temperature for storage is between 15°C -30°C (59°-86°F).

You should be able to travel with prednisolone eye drops as long as you declare the medication properly. You can take the medication in your checked luggage or less than 3.4 ounces (100 ml) on carry-on bags when declared.

Side Effects

If you develop symptoms of an allergy such as hives, swelling of your throat, lips, face, or tongue, or trouble breathing, get emergency medical care right away.

Common

Common side effects of prednisolone eye drops include:

• Mild burning or stinging of the eyes
• Blurry vision
• Eye irritation

Tell your healthcare provider if these symptoms get worse or don’t go away.

Severe

More severe side effects require emergency medical attention and include:

• Blurred vision, tunnel vision, seeing a halo effect around lights
• Eye pain or pain behind your eyes
• Patches of white or yellow on your eyes
• Any signs of infections such as pus, leakage, crustiness, swelling, and redness

Warnings and Interactions

Do not take any other eye medications while taking prednisolone eye drops unless you have your healthcare provider’s permission. Do not get a smallpox vaccine if you are taking prednisolone eye drops. You should not take this medication if you have eye infections.

Using this medication for longer than 10 days can increase your risk of developing cataracts. Your risk of optic nerve damage and vision defects may also increase with prolonged use.

Prednisolone eye drops can increase your risk of glaucoma,

• Some people are known as "steroid responders" in which steroid eye drop use will increase the pressure of the eye—leading to glaucoma.
• Your eye pressure will be checked at each follow-up by your eye doctor to make certain you are not a "steroid responder" and the medication is not increasing your pressure.
• There are certain steroid drops that are less likely to increase eye pressure, discuss this with your healthcare provider if you know you are a steroid responder, have a family history or risk for glaucoma, or have glaucoma.

Since extended use of steroids can reduce your immune system’s abilities, you may be at an increased risk for eye infections as well.

Your cornea and sclera may become thinner with prolonged use of steroid drops. Your healthcare provider will monitor these potential health risks closely.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. U.S. National Library of Medicine. Prednisolone ophthalmic.

2. Food and Drug Administration. Pred Mild.

3. Transportation Security Administration. What can I bring?

By Rachel Macpherson
Rachel MacPherson is a health writer, certified personal trainer, and exercise nutrition coach based in Montreal. 

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