Topical Steroids in Management of Dry Eye Disease

Purpose of Review: To review current literature on the use of topical steroids for treatment of both aqueous-deficient and evaporative subtypes of dry eye disease (DED). Recent Findings: Recent studies have shown that topical steroids are effective for the treatment of patients with moderate or severe DED who have failed to respond to more conservative measures. These medications are useful for patients with both aqueous-deficient and evaporative subtypes of DED. Although topical steroids are often used for a short period of time, patients with chronic ocular surface inflammation can benefit from long-term treatment. For this, low-potency steroids, such as loteprednol or fluorometholone, would be reasonable due to their reduced risk for increasing intraocular pressure. Topical steroids have proven beneficial in conjunction with other anti-inflammatory medications such as topical calcineurin inhibitors. Summary: As inflammation plays an important role in pathogenesis of DED, topical steroids may be considered for patients with refractory disease.