What is the primary reason for tapering topical ocular corticosteroids?

The primary reason for tapering topical ocular corticosteroids is to avoid the signs and symptoms of rebound ocular inflammation. When corticosteroids are used, particularly for extended periods, they suppress the inflammatory response in the eye. If therapy is suddenly discontinued, the eye may rebound with increased inflammation, resulting in significant discomfort or worsening of the original condition. Tapering the dose allows the ocular surface to gradually adjust and reduces the risk of rebound effects, providing a smoother transition off the medication.

In some cases, while issues such as adrenal insufficiency and elevated intraocular pressure due to steroid use are concerns, they are not the main focus when tapering corticosteroids. Similarly, while infections can be a secondary issue with corticosteroid use, the immediate concern when discontinuing therapy is typically the potential for rebound inflammation. Therefore, the importance of gradual tapering lies primarily in mitigating the inflammatory rebound effects, ensuring a more stable recovery for the patient.