Which corticosteroid is used for ocular surface inflammation/dry eye and can elevate IOP at 0.5% concentration?

• A. Fluorometholone 0.1%
• B. Difluprednate 0.05%
• C. Loteprednol 0.5%
• D. Prednisolone acetate 1%

Answer: (C)

Corticosteroids used for ocular surface inflammation and dry eye carry a risk of increasing intraocular pressure, and this risk depends on the potency and formulation of the steroid. Loteprednol etabonate is known as a “soft” steroid designed to minimize IOP elevation while still providing anti-inflammatory effects. It is available in a 0.5% concentration, which is the dose mentioned in the question, and at this strength it can elevate IOP—reflecting the trade-off between efficacy on the surface and safety in terms of pressure rise. Other options differ in concentration and potency (for example, milder fluorometholone at 0.1%, potent difluprednate at 0.05%, and potent prednisolone acetate at 1%), so they don’t fit the specific 0.5% formulation that’s associated with this IOP risk pattern.