I suffer from a condition called Ankylosing Spondylitis which is an inflammatory disorder of the lower back (my review on this condition will give you all the gory details). This has many symptoms and not all of them affect the lower back.

One such symptom is a condition called Iritis or Uveitis. This is an inflammation of the iris (coloured part of the eye) which manifests itself in several ways.

- A bloodshot or reddened eye (can be mistaken for conjunctivitis by GP's)
- A throbbing sensation in the eye
- Acute pain in the eye if you glance too quickly up or down or left or right.
- With your eyelids closed, just touching the eye with the slightest of pressure really hurts.

When presented with these symptoms most of us would initially visit our GP, as I did. Having had this problem a few times now I bypass my GP and go straight to the nearest Eye Casualty Department, which happens to be at the RVI Hospital in Newcastle. I would recommend you do the same if these symptoms become apparent, and believe me the staff will not think you're wasting their time if you have got Iritis.

Anyway, enough of my rambling. This review isn't about the condition as such, but more the prescription I am given (well it costs £6.40 a bottle) to treat it.

ABOUT PRED FORTE

Pred Forte, or Predisolone acetate to give it its pharmeceutical name, is a steroid (anti inflammatory drug). Coming in the form of milky white coloured eye drops, it is used for the short-term treatment of eye inflammation. It helps to reduce the irritation, burning, redness and swelling associated with eye inflammation.

BEFORE USE

Before prescribing Pred Forte a doctor should ask you, or you should tell your doctor if :-

- You are suffering or have suffered from any other eye complaint.
- You are pregnant or breast feeding.
- Are currently taking any other medication.
- You wear soft contact lenses, as the preservative used in these eye drops can damage such lenses.
- If you are suffering from a viral, fungal or bacterial eye infection.

Thankfully none of these apply to me although I'm asked most of them everytime I'm prescribed this drug, with the obvious exception of the pregnancy / breast feeding one.

DOSAGE

The usual dosage of Pred Forte is one or two drops applied two to four times daily. However, the actual dosage you may require depends on the severity of the eye inflammation. I have had to take it hourly on a couple of occasions for the first few days of treatment and then gradually reduce the dose over time. The doctor will advise you of your exact treatment regimen and would normally want to review the dosage within a week. As with most prescribed medicines you should keep using the drops until told to stop.

Although often used in isolation, Pred Forte is sometimes taken with other drugs depending on the exact nature of your eye complaint. I always have to use Pred Forte with two other drugs, so straight away the prescription cost is trebled. Thes drugs are:-

1) Cyclopentolate - or "Big Eye Drops" as I call them. These drops are used to dilate the pupil of your eye, which in turn increases the effectiveness of the Pred Forte. Your pupil literally dilates to almost the same size as your iris and this actually freaks quite a few people out, as your eye looks like a special effect from a horror movie. Word of warning, these sting when applied.

2) Betamethasone is a steroid ointment. It's applied to the eye prior to sleeping as an alternative to Pred Forte drops because it's longer lasting than the drops, this is particularly useful during the first few days of treatment. You may be wondering why not just use this instead of Pred Forte? The reason is that Betamethasone makes your vision blurred ( as you are effectively putting a load of grease into your eye) which renders it impractical for daytime use.

HOW TO APPLY

Not everybody can apply these themselves, particularly if you're sqeamish about eyes, it is though relatively straightforward. However, if you can't bring yourself to do it, ask somebody else. There are six steps to follow:-

1) Wash your hands.

2) Shake the bottle before use.

3) Tilt your head back and look at the ceiling.

4) Gently pull the lower eyelid down until there's a small pocket.

5) Squeeze the upturned dropper bottle to release a drop into the eye.

6) Release the lower eyelid and close your eye for 30 seconds. A small residue of fluid may run from your eye, so it's best to have a tissue ready.

You should avoid touching the dropper against your eye and remember to replace and tighten the cap after use.

One further tip, try not to sniff for a couple of minutes after applying the drops otherwise you end up with a rather unpleasant taste in your mouth. Just trust me on that one.

MISSED DOSES

If you forget a dose apply it as soon as you remember and then apply any remaining doses for that day at evenly spaced intervals. If however, it's almost time for your next dose, you should omit the missed dose and then follow your normal routine. I have been guilty of this a few times, especially if I'm at work.

SIDE EFFECTS

As with most drugs and medicines Pred Forte can have side effects. These include mild stinging and/or burning when applied and temporary blurred vision. If these effects are troublesome or prolonged you should consult a doctor immediately. I get a temporary blurring of vision following application, but this subsides after a minute or so.

More extreme (but very rare) side effects can be a thinning of the skin around the eye and the appearance of fine red lines on the face. Extremely rare cases of cataracts have been reported too. Glaucoma or a subsequent eye infection (hence the importance of washing your hands prior to application) can also cause Pred Forte to have an adverse effect on the eye. Thankfully none of this second group of side effects have bothered me.

STORAGE

As with all medicines Pred Forte should be kept out of the reach of children. Once opened it should ideally be kept in the fridge, but if this is impractical (ie fridge raiding children, no fridge at work or you're travelling) try to keep the drops in as cool a place as possible.

OTHER STUFF

This product should not be used if the seal around the neck of the dropper bottle has been broken upon receipt. Neither should it be used after its expiry date, although no reputable pharmacist should dispense such drugs. Most importantly though, the bottle should be thrown out 28 days after opening as axposure to air degrades the drugs effectiveness after this time.

DOES IT WORK ?

I've been prescribed Pred Forte several times now and it hasn't failed yet. It may take a matter of days and sometimes two to three weeks to clear up my eye problem, but than mainly depends on the severity of the problem. Usually the quicker the problem is diagnosed and treatment commences, the quicker it goes away.

My apologies if I've gone on a bit or cured anybody's insomnia with this review.