Which corticosteroid used in ophthalmology is an ester-based compound that undergoes rapid biotransformation to inactive metabolites by ocular tissue esterases, giving it a markedly reduced tendency to raise intraocular pressure?
- A Prednisolone acetate 1%
- B Loteprednol etabonate 0.5% ✓
- C Fluorometholone alcohol 0.1%
- D Rimexolone 1%
Correct answer: B. Loteprednol etabonate 0.5%
Explanation
Loteprednol etabonate is a 'soft steroid' designed with an ester at position C20 that is rapidly hydrolysed to inactive carboxylic acid metabolites by corneal and conjunctival esterases, limiting tissue accumulation and hence lowering steroid-response glaucoma risk. Fluorometholone also has low pressure-raising potential but achieves this through poor corneal penetration rather than enzymatic inactivation. Prednisolone acetate carries the highest IOP-elevating risk among common ophthalmic steroids.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.