Corneal ulceration may be aggravated by the presence of the steroid. It is important that corneal ulcers are correctly diagnosed before treatment with Terra-Cortril (oxytetracycline and hydrocortisone) is initiated.
Prolonged use of ophthalmic cortiocosteroids may result in glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation.
A steroid-glaucoma may be induced after a week or more of treatment in patients predisposed to chronic simple glaucoma. Furthermore, topical corticosteroid therapy frequently induces intraocular hypertension in normal eyes and increases pressure in eyes with initially elevated pressure. Intraocular pressure should be monitored frequently during therapy. In those diseases causing thinning of the cornea, perforation has been shown to have occurred with the use of topical steroids.
In acute purulent conditions, steroids may mask infection or enhance existing infection.
Local application of corticosteroids to the eyes of patients with bacterial, viral and fungal conjunctivitis may mask evidence of progression of infection until sight is lost.
Corticosteroids may cause progression of dendritic keratitis (herpes simplex infection) resulting in irreversible clouding of the cornea.
Prolonged use may supress the host response and thus increase the hazard of secondary ocular infections.
As with other antibiotic preparations, Terra-Cortril (oxytetracycline and hydrocortisone) may result in overgrowth of resistant organisms, particularly Candida and staphylococci.
Constant observation of the patient is essential.
If new infections of the cornea due to non-susceptible bacteria or fungi appear during therapy, appropriate measures should be taken.
If a favourable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.
If irritation develops the product should be discontinued and appropriate therapy instituted.
If these products are used for 10 days or longer, intraocular pressure should be routinely monitored.
Employment of steroid medication in the treatment of herpes simplex requires great caution.
The possibility of persistent fungal infections of the cornea should be considered after prolonged steroid dosing.
Supplemental therapy with oral oxytetracycline is advisable in the treatment of severe infections or those which may become systemic.
PREGNANCY AND LACTATION
†?The safety in pregnancy and lactation has not been established†Â
USE IN CHILDREN
Systemic administration of tetracyclines during tooth development (last half of pregnancy, infancy, and childhood to the age of 8 years) may cause permanent discoloration of the teeth as well as retardation in the development of the skeleton. Enamel hypoplasia has also been reported. Although these effects are unlikely following topical application of tetracyclines because of the low doses used, the possibility that these effects could occur should be considered.