For evening dosing, when should steroid eye drops be administered in a patient who uses contact lenses?

• A. Before inserting CLs
• B. Immediately after inserting CLs
• C. At bedtime
• D. After lenses are removed in evening

Answer: (D)

The key idea is that topical steroids must reach the ocular surface directly for effective absorption. Contact lenses can act as a reservoir, absorbing the medication and delivering it unevenly, which reduces drug efficacy and can alter how the medication interacts with the cornea and conjunctiva. By removing the lenses first and applying the steroid, you ensure the drug has direct access to the eye. After allowing a short absorption interval (typically about 10–15 minutes), the lenses can be reinserted. This approach maximizes efficacy and avoids the drug being trapped by the lens.