Which corticosteroid preparation is listed for treatment of Vernal Keratoconjunctivitis?

• A. Loteprednol 0.5% qid
• B. Prednisolone acetate 1% qd
• C. Dexamethasone 0.1% bid
• D. Fluorometholone 0.1% bid

Answer: (A)

When treating VKC, the goal is to control intense allergic inflammation while minimizing steroid-related side effects, especially in children. Loteprednol etabonate is a “soft” steroid designed to be active where inflammation occurs but rapidly deactivated in ocular tissues, which lowers the risk of rises in intraocular pressure and other adverse effects compared with more potent steroids.

The 0.5% concentration is a common, effective option for VKC, and dosing it four times daily provides strong anti-inflammatory effect to quell the severe signs and symptoms characteristic of VKC during flare-ups, while maintaining a safer overall safety profile.

Other corticosteroids listed are generally more potent or associated with higher risks of side effects such as IOP elevation or cataract with extended use, making loteprednol a preferred choice in VKC scenarios.