In significant ocular hyperemia, which treatment is recommended?

• A. Artificial tears
• B. Beta-blockers
• C. Topical steroids
• D. Oral antibiotics

Answer: (C)

When redness is driven by inflammation, treating the inflammatory process is the quickest way to reduce the visible hyperemia. Topical corticosteroids work by dampening the inflammatory response in the conjunctiva—lowering production of inflammatory mediators, reducing immune cell recruitment, and decreasing vascular dilation and permeability. This direct anti-inflammatory effect translates into less vessel engorgement and fewer symptoms when there is significant ocular redness accompanying inflammatory conditions such as allergic conjunctivitis, keratitis, or postoperative inflammation.

Artificial tears can help with irritation and dryness, but they don’t address the underlying inflammation that causes the redness. Beta-blockers are not anti-inflammatory fixes for the eye and are not used to treat hyperemia; they can even worsen dry eye symptoms. Oral antibiotics would only be appropriate if there is a bacterial infection, not for non-infectious inflammatory redness.

Topical steroids are best for significant inflammatory ocular hyperemia when used appropriately and under supervision, with careful consideration of potential side effects like increased intraocular pressure and infection risk.