I am a 27yrs old female patient. I have had epidemic keratoconjunctivitis for three weeks already. My face is not as swelling as I was last week. However, I am really afraid that using corticosteroids Lotemax(already stopped using) and Pred Forte(will start using) eye drops will make my right side face swollen permanently. Is this possible? Also, is using Pred Forte appropriate to treat corneal infiltrates caused by EKC? Thanks in advance for your help! Below is a timeline of my EKC.
Week of 3/24/14: The inner and outer corners of my right eye were really red. My ophthalmologist diagnosed me with viral eye infection and prescribed me TOBRADEX. I used TOBRADEX 3 times a day for the first two days, then 1 time a day for another 3 or 4 days, and then stopped.
Week of 3/31/14: My right eye became red and swollen. I went to see a new ophthalmologist and was told that I just had to wait for my body to fight the virus. No medicine was prescribed.
Week of 4/7/14: My right eye became even more red and swollen and My right face was very swollen as well. The lymph nodes on my right sides were also swollen. On Monday, I was prescribed Lotemax to reduce the inflammation and used it for 2 days, 3 times a day. Then, I noticed a big decrease in vision in my right eye and stopped the medicine. On Friday, my doctor told me that I have EKC and the virus is in my cornea as well. No pseudomembrane was detected. My doctor told me that I have two options: 1. Do not use medication. Wait for the eye to cure on its own, although it will take a long time. 2. Use steroid, but it takes even longer for the problem to be over. I chose not to use any medication.
Week of 4/14/14: Monday, I changed my ophthalmologist again. I went to see a cornea specialist at Weill Cornell ophthalmology. My doctor detected pseudomembrane and removed it. He also told me that I have a lot of corneal infiltrates and I must use Pred Forte eye drop.
Corneal subepithelial infiltrates in EKC clear very slowly, but do resolve. If they are in the center of the cornea and are affecting vision, a topical steroid (Lotemax or Pred Forte) can be used to speed resolution. The topical steroid will not cause facial swelling. Lotemax is a gentler steroid, with less potential to raise the eye pressure; hence, it is safer. Pred Forte is an excellent steroid, but your cornea specialist needs to monitor your eye pressure and lens while you are on it; Pred Forte can raise the eye pressure, and cause cataracts with prolonged use. These effects can be minimized with careful evaluation, and tapering of the dose as symptoms improve.
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