Double-blind clinical trial of topical steroids in anterior uveitis

We present the results of a double-blind trial comparing the efficacy of betamethasone phosphate 0.1%, clobetasone butyrate 0.1%, and placebo in the treatment of acute unilateral nongranulomatous uveitis. The 2 steroids were equally comparable in improvement of the patients' symptoms, though betamethasone phosphate was significantly more effective than clobetasone butyrate in improving the ocular signs of uveitis. However, clobetasone butyrate had significantly less effect on raising intraocular pressure in known steroid responders and ocular hypertensives than did dexamethasone. The use of a bolometer as an objective measure in uveitis was significant only in the more severe cases of uveitis. In comparing the placebo group of patients with those on topical steroids, the former group, though improving, appeared to lag behind by approximately one week. Four cases on placebo, however, had to be withdrawn because of worsening of the condition. Mild cases of anterior uveitis would probably resolve without using topical steroids.