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M. R. Wilkins, S. R. Khan, A. Khawaja, D. F. P. Larkin; Topical Steroids versus Placebo for Acute Follicular Conjunctivitis-A Prospective Randomised Controlled Trial. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2490. doi: https://doi.org/.
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Do topical steroids improve comfort and conjunctival inflammationin acute follicular conjunctivitis presumed to be caused byadenovirus infection?
Patients presenting with acute uni- or bilateral follicularconjunctivitis were randomised to dexamethasone 0.1% or maskedplacebo drops 4 times a day for 1 week. Exclusion criteria were:corneal staining/ dendrite, sub epithelial infiltrates, andglaucoma. Viral and chlamydial cultures were taken. At review5-7 days later patients graded, using a 4 point scale, whetherthey thought that the drops had helped. They also graded theirdiscomfort from 0-3. Conjunctival inflammation was graded usingthe Efron system.
112 patients were randomised, 88 attended for review. 16 wereculture positive for adenovirus, 1 for chlamydia and 0 for herpessimplex (HSV). The proportion of patients in whom the steroiddrops were considered helpful was insignificant (Table 1).Table 2 shows the mean discomfort. The differencein mean discomfort and mean conjunctival inflammation betweensteroid and placebo arms was insignificant.No patients developed signs of HSV. Two patientsrequired additional review, neither required additional treatment.The patient with chlamydia re-attended for further management.
Patients receiving topical steroids for acute follicular conjunctivitiswere not significantly more likely to report that they helpedcompared to those receiving placebo. There was no significantbenefit on discomfort or observed conjunctival inflammationsigns. Steroid drops did not exacerbate the conjunctivitis anddid not cause any harmful sequelae.
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