I was put on tobradex a little over two weeks ago and my doctor wants me on it for the month. I've read that intraocular pressure has to be monitored (they are monitoring mine) while i'm on it, but I'm going a month before there next measurement. Is it safe to use tobradex for a month? (i do one-two drops twice a day). I didn't know if going that long was normal or what not. Have any of you out there taken it for awhile without any major problems? Just wanted to be sure it wasn't causing more damage (it's not helping very much).

I have taken the steroid portion of tobradex - dexamethasone for a long time. But it is definitely one of the stronger steroids and can certainly make your intra-ocular pressure go up. My eye dr made me come in at least every 2 weeks while I was on it to get my pressure checked. The dexamethasone was wonderful for me because it really really helped with my itching and dryness and inflammation. It was the ONLY thing that helped. But then my IOP started to go up. Rather than take me off of it and have me go back to suffering as badly as I was prior to using it, my dr got the idea of just putting me on an anti-glaucoma drop to lower my IOP, and allow me to stay on the dexamethasone. That didn't really work too well and I had to come off of it because I developed floaters and flashers and had headches from the pressure. Keep in mind though, that I was on it for a lot longer than a month. It is safe to use as long as your IOP does not go up. In my opinion I would say that it is probably best to be checked every 2 weeks. You don't want to develop irreversible glaucoma.

The good thing is that most of the time if you develop high IOP and flashers and floaters from steroid use, it will return to normal with time after coming off of the steroids. Unless the doctor lets it go for too long. (In other words, if you develop problems and the dr keeps you on the steroids anyway). Fortunately for me my dr watched me very very closely and since he knew when to take me off, my high IOP and flashers and floaters went away. Unfortunately I am miserable from the dryness and itching that the dexamethasone was treating, and I need it badly but can probably never go back on it again. :(

I do have one friend who was on tobradex ointment for a while due to blepharitis and was only checked about once a month, but he never complained of any vision problems.

I would say that if you start to notice any pressure behind your eyes (sorta feels like a sinus headache) especially with eye movement, or if you start to develop any flashers or floaters, then you need to hurry back to the doctor. You should be checked while on it, but it differs for everyone. Call your doctor if you are concerned. Or, to be safe just make yourself an appointment for 2 weeks from the time you started. The doctor shouldn't stop you from coming in.