Fluorometholone 0.1% is used for ocular surface inflammation/dry eye; what is a potential adverse effect?

• A. Reduced IOP
• B. Can cause elevated intraocular pressure
• C. Systemic hypotension
• D. Conjunctival hyperemia only

Answer: (B)

When a topical ocular corticosteroid like fluorometholone is used, a key safety concern is the risk of raising the eye’s intraocular pressure in people who are sensitive to steroids. This occurs because steroids can affect the outflow pathways of the aqueous humor, leading to a buildup of pressure inside the eye. Even though fluorometholone is considered relatively milder, IOP elevation can still happen, especially with longer use, so monitoring the pressure is important to prevent steroid-induced glaucoma.

Other options don’t fit as well because reduced intraocular pressure isn’t a known adverse effect of topical steroids, and systemic hypotension isn’t expected with eye drops since systemic absorption is minimal. Conjunctival hyperemia can occur with some eye drops, but it’s not the primary or defining risk with fluorometholone; the more clinically significant concern is the potential for elevated IOP.