It IS HARD TO IMAGINE the practice of ophthalmology without corticosteroids. Fifty years ago the treatment options for uveitis included atropine drops, oral salicylates, direct application of heat to the eye, and induction of fever with typhoid vaccine or other proteins. Then, in 1949, Hench and associates1 described the beneficial effects of adrenocorticotropic hormone (ACTH) and cortisone in the treatment of rheumatoid arthritis. Within months of this seminal article it was clear that these drugs could help control ocular inflammation, and case reports began to appear. To read these articles is to share in the excitement and promise of a new era.
In 1949, Elkinton and associates2 described improvement of hemorrhagic retinopathy in a patient treated with ACTH for "generalized collagen disease." Three separate reports soon followed. Mann and Markson3 successfully controlled a patient's uveitis and episcleritis with ACTH therapy. Gordon and McLean4 described transient improvement
Raizman M. Corticosteroid Therapy of Eye DiseaseFifty Years Later. Arch Ophthalmol. 1996;114(8):1000-1001. doi:10.1001/archopht.1996.01100140208016