Eye Surgery Associates

Prednisolone is a type of steroid. It is closely related to cortisone and controls eye disease by dampening inflammation in the eye. It decreases redness and swelling and decreases the number and activity of white blood cells inside the eye and also at any other sites in the body where inflammation might be occurring (joints, chest or skin). It also decreases the ability of the body to fight infections.

What are the side effects?

Prednisolone is a powerful drug and side effects are common. In the short term fluid retention and weight gain are frequent, as are stomach upsets and indigestion and some mood disorders including a feeling of agitation and restlessness. In the long term prednisolone may cause high blood pressure, weakening of the bones (in women and men!) and a long term tendency to diabetes. This tendency to weakening of the bones (osteoporosis) is much higher in elderly patients and especially in post-menopausal women. It is possible to lessen the side effects on the bones by making sure that the diet is adequate in calcium, by getting adequate weight bearing exercise (eg walking), and by stopping smoking. Some women may benefit from hormone replacement therapy.

In addition, there are side effects if prednisolone is stopped suddenly; this may cause a feeling of weakness and even very low blood pressure. Prednisolone increases one's risk of infections. It is important that one should minimise exposure to people who may have an infectious disease and especially to little children who may have chicken pox or to adults who have shingles. If you think you may have been exposed to an infection, especially to chicken pox, while on prednisolone you should let your local doctor or your eye doctor know promptly. Prednisolone is only given to you after careful consideration of the possible side effects and the benefits that may be gained by the treatment.

What are the alternatives?

Some people with inflammation in their eyes do not require any treatment at all. If the inflammation is mild then treatment may be with steroid drops or a steroid injection under the eye rather than with prednisolone tablets. In general prednisolone tablets are reserved for those patients with severe vision threatening disease. If the prednisolone helps your eye but the side effects are too severe then there are alternatives to prednisolone, which may be used in the long term. If at any stage you feel the side effects of the prednisolone are worse than the visual loss from the uveitis, then it may be that you would be better off stopping the treatment and putting up with your poor vision.

Should I tell my doctor?

Yes, you should always let your doctor or dentist know that you are on prednisolone if you have other illness or are requiring an operation or are being started on any tablets. In fact you should let your doctor know that you have been on prednisolone even if it is six months since you stopped it.

What should I do if I have problems?

If you have any problems or serious illness whilst on the prednisolone you should take them seriously. If you develop a temperature or any signs of infection you should contact your eye doctor or your local doctor promptly. If you have any questions at all do not hesitate to ask your eye doctor.