Pred Forte (prednisolone acetate ophthalmic suspension) 1% is a prescription ophthalmic corticosteroid specifically formulated for the treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe. It is a mainstay in ophthalmic therapeutics, offering clinicians a trusted option for managing a spectrum of inflammatory and allergic ocular disorders. Its micronized suspension ensures optimal drug delivery and bioavailability at the site of action, providing targeted anti-inflammatory and immunosuppressive effects to rapidly reduce swelling, redness, and discomfort.

Features

• Active Ingredient: Prednisolone acetate 1% (10 mg/mL)
• Dosage Form: Sterile, preservative-free (in single-use vials) or preserved (benzalkonium chloride 0.01% in multi-dose bottle) ophthalmic suspension.
• Presentation: White to off-white, micronized suspension that readily resuspends upon shaking.
• Mechanism of Action: Corticosteroid that inhibits the inflammatory response to a variety of agents by suppressing edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, and collagen deposition.
• Packaging: Available in 5 mL, 10 mL, and 15 mL dropper bottles, and in individual 0.4 mL single-use dropperettes.
• pH: Adjusted to approximately 5.0 with sodium citrate and citric acid to maximize comfort upon instillation.
• Osmolality: Approximately 250 mOsm/kg.

Benefits

• Rapid and Potent Anti-Inflammatory Action: Effectively suppresses the key mediators of inflammation, leading to a swift reduction in ocular redness, swelling, pain, and photophobia.
• Superior Corneal Penetration: The unique acetate ester form and micronized particle size are engineered for enhanced corneal absorption compared to other steroid preparations, ensuring therapeutic levels are reached in the anterior chamber.
• Prevention of Tissue Damage: By controlling excessive inflammation, it helps prevent scarring, vascularization, and other sight-compromising complications that can arise from unchecked inflammatory processes.
• Symptom Relief and Improved Comfort: Patients experience significant relief from the itching, burning, and grittiness associated with inflammatory eye conditions, improving quality of life and visual function during treatment.
• Flexible Dosing Regimens: Allows ophthalmologists to tailor the treatment frequency and duration based on the severity of the condition, from intensive hourly dosing to a gradual tapering schedule.
• Trusted Clinical Profile: Decades of widespread use and clinical studies support its efficacy and safety when used appropriately under specialist supervision.

Common use

Pred Forte is indicated for the treatment of steroid-responsive inflammatory conditions of the eye. Its use is common in post-operative care and for managing specific disease states.

• Post-operative Inflammation: Management of inflammation following ocular surgery, including cataract extraction, corneal transplant, and glaucoma filtering procedures.
• Anterior Uveitis (Iritis/Iridocyclitis): Treatment of non-infectious inflammation of the uveal tract in the anterior chamber.
• Allergic Conjunctivitis: Severe allergic and vernal conjunctivitis that is unresponsive to conventional mast-cell stabilizer and antihistamine therapy.
• Keratitis: Superficial punctate keratitis, herpes zoster keratitis (after the epithelial defect has healed), and adenoviral keratitis in the later stages to mitigate subepithelial infiltrates.
• Corneal Injury: Inflammatory conditions of the cornea such as chemical burns, thermal burns, or penetration of foreign bodies.
• Episcleritis and Scleritis: (Note: deeper forms of scleritis often require systemic therapy).

Dosage and direction

Dosage must be individualized based on the severity of the inflammatory condition. The following is a general guideline; always follow the specific instructions provided by the prescribing ophthalmologist.

1. Shake the bottle vigorously for 10-15 seconds before each use to ensure a uniform suspension.
2. Wash hands thoroughly.
3. Tilt head back and pull down the lower eyelid to form a pouch.
4. Instill the prescribed number of drops (typically 1 or 2 drops) into the conjunctival sac of the affected eye(s). Avoid touching the dropper tip to any surface, including the eye, to prevent contamination.
5. Gently close the eye and apply light pressure to the nasolacrimal duct (the inner corner of the eye next to the nose) for 1-2 minutes. This minimizes systemic absorption.
6. Initial Therapy: For severe conditions, dosing may be as frequent as 1 to 2 drops every hour during waking hours.
7. Tapering: As inflammation subsides, the frequency of application should be reduced gradually. A typical tapering schedule might progress from every 2 hours, to 4 times daily, to twice daily, to once daily over 1-2 weeks. Abrupt discontinuation may lead to a rebound of inflammation.
8. If using other topical ophthalmic medications, administer them at least 5-10 minutes apart. Ointments should always be applied last.

Precautions

• Ophthalmologist Supervision: This is a potent medication that requires close monitoring by an eye care specialist. Do not use without a prescription.
• Intraocular Pressure (IOP) Monitoring: Prolonged use can cause a significant elevation in IOP in susceptible individuals (steroid responders), which may result in glaucomatous damage to the optic nerve with potential loss of visual field. IOP should be checked every 2-4 weeks during treatment, especially in patients with a history of glaucoma.
• Cataract Formation: Prolonged use may lead to the formation of posterior subcapsular cataracts.
• Infection Risk: Corticosteroids may suppress the host immune response, thereby increasing the susceptibility to, and masking the signs of, secondary ocular infections. Fungal infections of the cornea are particularly notorious and can be devastating. Any persistent corneal ulceration where steroid use is involved should be suspected of being fungal.
• Perforation Risk: Use in eyes with thin corneas (e.g., after surgery, disease, or injury) may delay wound healing and increase the risk of corneal or scleral perforation.
• Viral Infection: Extreme caution is required in patients with a history of herpes simplex keratitis. Corticosteroids may facilitate viral replication and reactivate latent disease.

Contraindications

Pred Forte is contraindicated in the following scenarios:

• Active Epithelial Herpes Simplex Keratitis (Dendritic Keratitis): Steroids can exacerbate the viral infection, leading to geographic ulcers and severe corneal damage.
• Vaccinia, Varicella, and most other Viral Diseases of the cornea and conjunctiva.
• Active Ocular Tuberculosis.
• Active Fungal, Mycobacterial, or Bacterial Ocular Infections not adequately controlled by appropriate anti-infective agents.
• Hypersensitivity to any component of the formulation (prednisolone acetate, benzalkonium chloride, etc.).

Possible side effect

While not everyone will experience side effects, the following have been reported:

• Common: Temporary blurred vision or stinging/burning upon instillation.
• Serious (Require Immediate Medical Attention):
  • Significant, persistent increase in intraocular pressure (steroid-induced glaucoma).
  • Development of posterior subcapsular cataracts with long-term use.
  • Secondary ocular infections from bacteria, fungi, or viruses.
  • Corneal or scleral thinning, leading to perforation.
  • Delayed wound healing.
  • Exophthalmos.
  • Allergic reactions, including rash, itching, and swelling of the face or eye.
  • Systemic effects are rare but possible with significant absorption, especially in children.

Drug interaction

• Other Topical Eye Medications: If multiple drops are used, they should be administered at least 5-10 minutes apart to prevent wash-out and allow for proper absorption. Inform your doctor of all medications you are using.
• Systemic Corticosteroids: Concurrent use with systemic steroids (e.g., oral prednisone) could potentially increase the risk of systemic corticosteroid side effects, although the contribution from topical ophthalmic use is generally low.

Missed dose

• If you miss a dose, instill it as soon as you remember.
• If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
• Do not double the dose to make up for a missed one.

Overdose

• Topical overdose is unlikely to cause life-threatening systemic effects due to minimal absorption.
• Symptoms of an ocular overdose would likely be an exacerbation of local side effects (severe irritation, redness).
• If a large quantity is accidentally ingested, seek medical attention or contact a Poison Control center immediately. Systemic corticosteroid effects like hyperglycemia could occur.

Storage

• Store at controlled room temperature 20°C to 25°C (68°F to 77°F). Do not freeze.
• Keep the bottle tightly closed when not in use.
• Protect from light.
• Multi-dose bottles: Discard the bottle 28 days after opening. Write the date of opening on the bottle label to track.
• Single-use dropperettes: Use immediately after opening. Discard any unused portion after one use; they do not contain a preservative.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your ophthalmologist or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The manufacturer and publisher are not responsible for any errors in content or for any actions taken based on this information.

Reviews

• Clinical Ophthalmologist, 20+ years experience: “Pred Forte remains my go-to steroid for significant anterior segment inflammation. Its penetration is superior to other formulations, and I see a predictable and rapid response in my uveitis and post-op patients. The key, of course, is vigilant monitoring for pressure spikes.”
• Patient with Recurrent Anterior Uveitis: “I’ve had iritis flares for years. When I feel one coming on, I start my Pred Forte drops as directed. The pain and light sensitivity start to improve within a day. It’s a powerful medication, but it’s what keeps my vision clear. I never skip my pressure check appointments.”
• Corneal Specialist: “In cases of severe allergic keratoconjunctivitis, a short, intensive course of Pred Forte can break the cycle of inflammation and provide immense relief when other medications fail. We use it judiciously and with a clear exit strategy to taper.”
• Post-Cataract Surgery Patient: “After my cataract surgery, I used these drops on a tapering schedule for a few weeks. My eye was never red or painful. The instructions were clear to shake the bottle well, and the drops were comfortable to use.”