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The ocular surface is constantly bathed by tears, which provide nutrition and protection to the ocular surface epithelium. The milieu of the ocular surface, including the fluids and electrolytes are maintained in a steady state. A well balanced ocular surface milieu is important for the well being of the ocular surface. Topically applied eye drops can alter the milieu of the tear pool.1 Although manufacturers adjust the pH and osmolarity so that they are close to that of the normal conjunctival surface, the electrolyte levels are not adjusted to physiological levels. Deviation of electrolyte concentrations of topically applied drops from physiological concentrations may be implicated in crystalline keratopathy.2–8 We therefore evaluated the electrolyte levels of different topical steroid drops.
Nine different types of topical steroid drops were analysed (vistamethasone, maxidex, prednisolone sodium phosphate 0.1% (preservative free), …