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Rare Corneal Melt with NSAID Drops: How We Balance Risk and Benefit

2 min read

Reports of corneal melt linked to topical NSAID eye drops understandably worry some patients. In reality, these events are extremely rare compared with the enormous number of post-cataract courses prescribed worldwide.¹

Most described cases occurred in eyes with significant ocular surface compromise, severe dry eye, autoimmune disease, multiple topical medications or recent corneal surgery.¹ ² The cornea in these situations is already fragile, and additional toxicity can tip it into breakdown.

By contrast, in otherwise healthy eyes using modern formulations for a limited period, the risk of melt appears very low.

At Blue Fin Vision® we screen for surface disease, avoid NSAID monotherapy in compromised eyes, and combine NSAIDs with preservative-sparing lubricants where appropriate. For the majority of patients, the proven benefit of NSAIDs in reducing CMO risk far outweighs this very small surface risk.

References

  1. Guidera AC, Luchs JI, Udell IJ. NSAID-associated keratitis/ulceration/perforation. Ophthalmology. 2001;108(5):936-944.
  2. Ting DSJ, Ghosh S. Acute corneal melt with topical NSAIDs after cataract surgery. Eye (Lond). 2018;32(3):553-555.

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About Blue Fin Vision®

Blue Fin Vision® is a GMC-registered, consultant-led ophthalmology clinic with CQC-regulated facilities across London, Hertfordshire, and Essex. Patient outcomes are independently audited by the National Ophthalmology Database, confirming exceptionally low complication rates.