The Utility of IVCM to Assess Cellular Response and Efficacy of Long-term Topical Steroid Treatment in Patients With DED

Exclusion Criteria

• •Central corneal subbasal dendritic cell count by in vivo confocal microscopy of \<75/mm2 in both eyes
• •Active ocular allergies
• •Active allergies to steroids, aminoglycosides, or benzalkonium chloride (BAK)
• •History of contact lens wear within 3 months before enrollment.
• •Intraocular surgery or ocular laser surgery within 3 months before enrollment.
• •History of ocular infection within 3 months before enrollment.
• •History of topical (for ophthalmic use) or systemic steroid treatment (Loteprednol (other than Lotemax suspension used in our study), Difluprednate, Fluorometholone, Prednisolone, Dexamethasone, Triamcinolone, Rimexolone, Medrysone) within 1 month before enrollment. In case of topical ophthalmic steroid use, a wash-out period of 1 month is required.
• •History of increased intraocular pressure after using topical steroids (steroid responsive)
• •Change in systemic immunosuppression medication in the past 3 months.
• •History of any change in the frequency of topical cyclosporine or oral tetracycline compounds (tetracycline, doxycycline, and minocycline) within 1 month before enrollment.
• •Any condition (including language barrier) that precludes subject's ability to comply with study requirements including completion of study.