What should be verified before placing a steroid in an eye?

What should be verified before placing a steroid in an eye?

• A. Ensure there is NO ulceration or perforations.
• B. Confirm there is an active infection.
• C. Apply anesthetic first.
• D. Start a steroid immediately for redness.

Answer: (A)

The key idea is that topical corticosteroids can delay corneal healing and worsen any breakdown of the corneal surface. Therefore, you must first confirm there is no ulceration or full-thickness perforation before placing a steroid in the eye. In horses, this is checked with a fluorescein stain and a careful slit-lamp exam to detect any epithelial defect or iris exposure. If an ulcer is present or perforation is suspected, steroids are avoided and the ulcer is treated—typically with appropriate antibiotics, lubricants, and analgesia—and steroids are considered only after healing and infection control. If there is active infection, steroids can also worsen it, so the absence of ulceration is the essential verification before use.

The key idea is that topical corticosteroids can delay corneal healing and worsen any breakdown of the corneal surface. Therefore, you must first confirm there is no ulceration or full-thickness perforation before placing a steroid in the eye. In horses, this is checked with a fluorescein stain and a careful slit-lamp exam to detect any epithelial defect or iris exposure. If an ulcer is present or perforation is suspected, steroids are avoided and the ulcer is treated—typically with appropriate antibiotics, lubricants, and analgesia—and steroids are considered only after healing and infection control. If there is active infection, steroids can also worsen it, so the absence of ulceration is the essential verification before use.