FML Forte vs. Other Eye Steroid Drops: Which Is Best?
When your eye feels inflamed after surgery or an allergic flare‑up, you’ll often be handed a bottle of Fluorometholone. But is it really the right choice, or could another eye steroid give you the same relief with fewer side effects? This guide breaks down FML Forte and the most common alternatives, so you can decide which drop fits your needs.
What Is Fluorometholone (FML Forte)?
Fluorometholone is a medium‑potency synthetic corticosteroid formulated as a 0.1% ophthalmic suspension, sold under the brand name FML Forte. It was first introduced in the 1970s and quickly became popular for postoperative inflammation, uveitis, and severe allergic conjunctivitis because it offers strong anti‑inflammatory action while sparing the eye’s natural barrier more than higher‑potency steroids.
Typical dosing is one drop four times daily for the first few days, then tapering over 1‑2weeks depending on the clinician’s assessment.
Key Criteria for Comparing Eye Steroids
- Potency: How powerful the drug is at reducing inflammation.
- Onset of Action: How quickly patients notice symptom relief.
- Risk of Increased Intra‑ocular Pressure (IOP): Steroids can raise eye pressure, leading to glaucoma if not monitored.
- Duration of Effect: How long a single drop remains active.
- Safety in Sensitive Situations: E.g., use after cataract surgery, in children, or in patients with a history of steroid‑responsive glaucoma.
- Cost & Availability: Price per bottle in Australian pharmacies and whether it’s covered by the PBS.
Top Alternatives to FML Forte
Below are the most frequently prescribed eye steroids that sit next to Fluorometholone on a doctor’s formulary.
Prednisolone acetate (brand Pred Forte) is a high‑potency corticosteroid available as a 1% suspension. It provides rapid inflammation control but carries a higher IOP‑rise risk.
Loteprednol etabonate (brand Lotemax) is a soft‑drug corticosteroid designed to break down quickly in ocular tissues, reducing IOP spikes while still offering strong anti‑inflammatory effects.
Dexamethasone (brand Dexasone) is a very high‑potency steroid often reserved for severe uveitis. Its powerful action comes with a notable risk of cataract formation and glaucoma.
Hydrocortisone (0.5% suspension) is a low‑potency steroid used for mild allergic conjunctivitis. It’s gentle on IOP but may be insufficient for postoperative inflammation.
Some clinicians also prescribe Non‑steroidal anti‑inflammatory eye drops (e.g., ketorolac) as adjuncts or alternatives when steroids are contraindicated.
Side‑Effect Profile Compared
| Drug | IOP Rise (Low/Mod/High) | Cataract Risk | Typical Indication |
|---|---|---|---|
| Fluorometholone | Low‑to‑moderate | Low | Post‑op inflammation, moderate uveitis |
| Prednisolone acetate | Moderate‑to‑high | Moderate | Severe postoperative, uveitis |
| Loteprednol etabonate | Low | Very low | Allergic conjunctivitis, mild post‑op |
| Dexamethasone | High | High | Severe uveitis, retinal inflammation |
| Hydrocortisone | Low | Negligible | Mild allergic reactions |
In practice, patients with a history of steroid‑responsive glaucoma are usually steered toward Loteprednol or even a low‑potency Hydrocortisone regimen. If rapid control is essential-say after cataract extraction-many surgeons start with Prednisolone acetate then taper to Fluorometholone to limit IOP exposure.
Cost and Accessibility in Australia (2025)
Price points can influence the final decision, especially for longer tapering courses.
- FML Forte (30drops): AU$12‑$15, PBS‑eligible for most concession card holders.
- Pred Forte (30drops): AU$20‑$25, generally not PBS‑listed.
- Lotemax (30drops): AU$30‑$35, higher due to soft‑drug technology.
- Dexamethasone (30drops): AU$22‑$27, occasional bulk discounts for hospitals.
- Hydrocortisone (30drops): AU$8‑$10, widely available over the counter.
For a typical 2‑week postoperative course, the total out‑of‑pocket cost for Fluorometholone often ends up lower than its high‑potency peers, making it a budget‑friendly option without sacrificing efficacy.
Bottom Line: When to Choose Fluorometholone
If you need a steroid that balances potency with a safer IOP profile, FML Forte sits in the sweet spot. It’s especially suitable for:
- Standard cataract or laser eye‑surgery recovery.
- Moderate anterior uveitis where a quick taper is desired.
- Patients with a mild‑to‑moderate history of steroid‑induced pressure spikes.
- Anyone looking for a PBS‑subsidised option.
Reserve higher‑potency agents like Pred Forte or Dexamethasone for cases where inflammation is aggressive or refractory. Opt for low‑potency Hydrocortisone or NSAID drops when the inflammation is mild or when steroids are contraindicated.
Key Takeaways
- Fluorometholone offers medium potency with a lower risk of IOP elevation compared to many high‑potency steroids.
- Loteprednol etabonate is the safest for pressure‑sensitive eyes but comes at a higher price.
- Prednisolone acetate delivers the strongest anti‑inflammatory punch but demands close IOP monitoring.
- Cost‑wise, FML Forte is often the most affordable PBS‑listed option in Australia.
- Choosing the right drop hinges on inflammation severity, glaucoma risk, and budget.
Frequently Asked Questions
Can I use Fluorometholone after LASIK?
Yes. Many ophthalmologists prescribe a short 5‑day course of FML Forte post‑LASIK to control mild inflammation. Because its IOP‑rise risk is low, it’s a safe choice for most patients.
What should I do if my eye pressure goes up while using eye steroids?
Stop the steroid immediately and contact your eye‑care professional. They may switch you to a low‑risk option like Loteprednol or add a pressure‑lowering eye drop. Regular IOP checks are standard during any steroid course lasting more than a week.
Is Fluorometholone safe for children?
It can be used in children, but dosage and duration are usually shorter. Pediatric eyes are more prone to steroid‑induced cataract, so doctors monitor IOP closely.
How does Fluorometholone compare to over‑the‑counter eye drops?
OTC drops (e.g., artificial tears or antihistamine drops) relieve dryness or mild itch but lack the anti‑inflammatory power of a steroid. If your doctor has prescribed FML Forte, it’s because the inflammation is beyond what OTC products can handle.
Can I use Fluorometholone with contact lenses?
It’s best to remove lenses before instilling the drop, wait a few minutes, then re‑insert. The suspension can coat lenses and reduce vision clarity.
Bernard Lingcod
October 13, 2025 AT 16:34Balancing inflammation control with IOP safety is key, especially after cataract surgery where you want a smooth recovery without extra glaucoma risk. Fluorometholone sits nicely in that middle ground, offering enough punch to calm the postoperative flare while keeping pressure spikes low for most patients. The PBS subsidy in Australia also makes it a cost‑effective option compared to many of the high‑potency counterparts. If you’re on the fence, think about the typical taper schedule and how that plays into your daily routine.