Role of steroids in the treatment of bacterial keratitis

Sotiria Palioura, Christopher R. Henry, Guillermo Amescua, Eduardo C. Alfonso

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Bacterial keratitis can lead to severe visual impairment from corneal ulceration, subsequent scarring, and possible perforation. The mainstay of treatment is topical antibiotics, whereas the use of adjunctive topical corticosteroid drops remains a matter of debate. Herein, we review the rationale for and against the use of topical corticosteroids and we assess their effectiveness and safety in the published randomized controlled trials that have evaluated their role as adjunctive therapy for bacterial corneal ulcers. In the largest study to date, the Steroids for Corneal Ulcers Trial, topical corticosteroid drops were neither helpful nor harmful for the 500 participants as a whole. However, subgroup analyses suggested that topical corticosteroids may be beneficial upon early administration (within 2–3 days after starting antibiotics) for more central corneal ulcers with poorer vision at presentation, for invasive Pseudomonas strains, and for non-Nocardia ulcers. These results are discussed within the limitations of the study.

Original languageEnglish (US)
Pages (from-to)179-186
Number of pages8
JournalClinical Ophthalmology
StatePublished - Jan 27 2016


  • Antibiotic
  • Corneal ulcer
  • Endophthalmitis
  • Eye infection
  • Perforation
  • Topical corticosteroids

ASJC Scopus subject areas

  • Ophthalmology


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