A randomised placebo-controlled trial of topical steroid in presumed viral conjunctivitis.
OBJECTIVE
To assess whether topical steroids improve patient comfort compared with hypromellose in acute presumed viral conjunctivitis.


METHODS
Patients presenting with acute follicular conjunctivitis, presumed viral in origin, were randomised to receive either dexamethasone 0.1% or hypromellose 0.3% drops four times daily for 1 week. At review after 5-7 days patients completed questionnaires on whether they thought the treatment had helped and on their level of discomfort. A physician assessed conjunctival hyperaemia using a grading scale.


RESULTS
111 patients were randomised: 56 received dexamethasone drops and 55 received hypromellose lubricant drops. Eighty-eight returned for review. Most patients (39/45 (87%)) receiving dexamethasone and most of those receiving hypromellose 30/43 (70%) felt that the treatment helped. Analysis of all responses showed a significant difference between treatments (p=0.0248, rank sum test). No significant differences between dexamethasone and hypromellose arms were found in the patients' perceived level of discomfort or the physician grading of conjunctival hyperaemia. No patient experienced a serious complication.


CONCLUSIONS
There us now evidence to support the use of a short course of topical dexamethasone for patients presenting with acute follicular conjunctivitis presumed to be viral in origin. Where topical dexamethasone is prescribed we have not found it to be harmful.


BACKGROUND
http://www.controlled-trials.com/ISRCTN50728656.
Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK. mail@markwilkins.co.uk
Mark R
MR
Wilkins
Sharmina
S
Khan
Catey
C
Bunce
Anthony
A
Khawaja
Dilani
D
Siriwardena
Daniel F P
DF
Larkin
D000208:Acute Disease; D000256:Adenoviridae / Q000235:genetics / Q000302:isolation & purification; D000257:Adenoviridae Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D003228:Conjunctiva / Q000473:pathology / Q000821:virology; D003236:Conjunctivitis, Viral / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D016896:Treatment Outcome
D004279:DNA, Viral; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone