Pred Forte (prednisolone acetate ophthalmic suspension) 1% is a high-potency, topical corticosteroid formulation specifically engineered for the management 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, valued for its superior suspension technology that enhances bioavailability and tissue penetration, ensuring effective delivery to ocular structures. This medication is indicated for short-term use under careful supervision to mitigate risks associated with prolonged steroid exposure, including elevated intraocular pressure and cataract formation. Its clinical utility spans a broad spectrum of inflammatory and allergic ocular pathologies, making it an indispensable tool in both acute and chronic management protocols.

Features

• Active Ingredient: Prednisolone acetate 1.0%
• Formulation: Sterile, preserved ophthalmic suspension
• Vehicle: Hydroxypropyl methylcellulose-based suspension for optimal corneal contact time
• pH: Adjusted to physiological range (approximately 6.5–7.5) to minimize irritation
• Preservative: Benzalkonium chloride 0.01%
• Packaging: 5mL, 10mL, and 15mL sterile dropper bottles

Benefits

• Rapid suppression of ocular inflammation, reducing pain, photophobia, and blurred vision
• High bioavailability due to unique suspension properties that enhance corneal penetration
• Effective across a wide spectrum of steroid-responsive anterior segment diseases
• Flexible dosing regimens adaptable to severity of inflammation
• Prevents sight-threatening complications from uncontrolled intraocular inflammation
• Minimizes risk of systemic corticosteroid side effects through localized delivery

Common use

Pred Forte is routinely prescribed for the treatment of steroid-responsive inflammatory conditions of the eye. Its primary applications include management of anterior uveitis (iritis, iridocyclitis), postoperative inflammation following cataract extraction and other ocular surgeries, allergic conjunctivitis severe enough to warrant steroid intervention, and inflammatory manifestations of corneal conditions such as herpes zoster ophthalmicus (after epithelial healing) and interstitial keratitis. It is also used off-label in certain cases of scleritis and episcleritis when non-steroidal anti-inflammatory drugs prove insufficient. The decision to initiate therapy should always follow a comprehensive ophthalmic examination, including slit-lamp evaluation and measurement of baseline intraocular pressure.

Dosage and direction

Shake the bottle vigorously for at least 10 seconds before each use to ensure uniform suspension. The typical starting dose is 1 to 2 drops instilled into the conjunctival sac of the affected eye(s) every 4 to 6 hours during the initial 24 to 48 hours of treatment. Depending on the severity of inflammation, dosing frequency may be intensified to hourly administration in acute, severe cases under close monitoring. As clinical response is achieved, the frequency should be tapered gradually over 1 to 2 weeks to avoid rebound inflammation. Do not discontinue abruptly. Patients should be instructed to avoid touching the dropper tip to any surface to prevent contamination.

Precautions

Use with extreme caution in patients with a history of ocular herpes simplex (may facilitate viral replication); glaucoma (steroid responders); and corneal thinning or perforation. Intraocular pressure should be monitored at least every 2–4 weeks during therapy, even in patients without prior history of glaucoma. Extended use increases risk of posterior subcapsular cataract formation. Bacterial, fungal, or viral ocular infections may be masked or exacerbated by corticosteroid use. Contact lens wear is contraindicated during treatment due to preservative (benzalkonium chloride) absorption and potential for irritation. Use in pregnancy only if potential benefit justifies potential risk to fetus (Category C).

Contraindications

Absolute contraindications include active untreated ocular infections (bacterial, viral, fungal, or mycobacterial); hypersensitivity to prednisolone acetate or any component of the formulation; and most cases of active epithelial herpes simplex keratitis (dendritic keratitis). Relative contraindications include known history of steroid-induced intraocular pressure elevation; pre-existing glaucoma; ocular mycobacterial infection; and perforated corneal or scleral wounds.

Possible side effect

Common side effects include transient blurred vision or stinging upon instillation (reported in up to 15% of patients); elevated intraocular pressure (in approximately 30% of the population after 4–6 weeks of use); and delayed wound healing. Less frequent adverse effects include posterior subcapsular cataract formation with prolonged use; secondary ocular infection from bacteria, fungi, or viruses; corneal or scleral thinning; ptosis; mydriasis; and conjunctival hyperemia. Rare systemic absorption may theoretically cause systemic corticosteroid effects, though this is uncommon with appropriate topical use.

Drug interaction

Concurrent use with other ocular corticosteroids (systemic or topical) may have additive effects in elevating intraocular pressure or suppressing the immune response. Caution is advised when using with other preserved ophthalmic solutions due to potential for additive preservative toxicity. No clinically significant pharmacokinetic interactions with systemic medications have been documented, though pharmacodynamic interactions with other immunosuppressants are possible.

Missed dose

If a dose is missed, it should be administered as soon as remembered. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling up on doses is not recommended. Patients should be educated on the importance of adherence to the prescribed regimen, especially during the initial high-frequency phase, to achieve rapid inflammatory control.

Overdose

Topical ocular overdose is unlikely to cause serious systemic effects due to minimal absorption. However, excessive instillation may result in increased local side effects such as severe ocular irritation, conjunctival hyperemia, or elevated intraocular pressure. Treatment is supportive and includes ocular irrigation with sterile saline if indicated. In case of accidental ingestion, seek medical attention; systemic corticosteroid effects such as hyperglycemia or adrenal suppression could occur, though this is highly improbable given the low volume per bottle.

Storage

Store at controlled room temperature (15°–30°C or 59°–86°F). Protect from light and freezing. Keep the bottle tightly closed when not in use. Discard any unused suspension 28 days after opening the bottle to minimize risk of contamination or loss of potency. Do not use if the suspension appears discolored or contains particulate matter beyond the expected resuspended particles.

Disclaimer

This information is intended for educational purposes and does not replace 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 therapeutic regimen. Never disregard professional medical advice or delay in seeking it because of something you have read herein. Individual patient responses to Pred Forte may vary, and therapeutic decisions should be based on a thorough clinical evaluation.

Reviews

“As an anterior segment specialist for over 20 years, Pred Forte remains my go-to for severe anterior uveitis flares. The suspension technology truly delivers superior drug levels to the anterior chamber compared to other steroids. My patients consistently report rapid symptom relief. Monitoring IOP is non-negotiable, but the efficacy profile justifies the vigilance.” – Ophthalmologist, Boston

“Prescribed Pred Forte post-cataract surgery. The inflammation was significantly reduced within two days. Instructions were clear about shaking the bottle, which I did religiously. Experienced slight blurring for a minute after each drop, but that was expected. Completed the tapering protocol with no rebound inflammation.” – Patient, 68

“In our clinic, we reserve Pred Forte for cases where potent steroid activity is warranted. It’s particularly effective in allergic conjunctivitis cases that don’t respond to mast cell stabilizers or antihistamines. We always emphasize close follow-up for IOP checks, especially in known responders.” – Optometrist, Chicago

“Used for bilateral anterior uveitis. The four-times-daily dosing was manageable. My ophthalmologist monitored my pressure every two weeks—no significant rise. The inflammation resolved completely over three weeks with proper tapering. Appreciated the detailed instructions on administration technique.” – Patient, 42