Eysuvis Side Effects: What to Expect and When to Call Your Doctor

Eysuvis (loteprednol etabonate ophthalmic suspension 0.25%) is a prescription corticosteroid eye drop used for the short-term treatment of dry eye disease. Like all corticosteroid eye drops, it can cause side effects — though most patients in clinical trials tolerated it well over the approved 2-week treatment course. This guide walks through the full safety profile so you know what to watch for.

The Most Common Side Effect: Instillation Site Pain

In clinical trials involving approximately 2,900 patients with dry eye disease, the most common adverse reaction reported with Eysuvis was instillation site pain, occurring in 5% of patients. This means that in studies, 95% of patients did not report significant pain upon instillation — a favorable tolerability profile compared to some other ophthalmic medications.

The instillation discomfort, when it occurs, typically presents as a brief burning, stinging, or irritation sensation immediately after placing the drops in your eye. This generally resolves within a minute or two.

Other Common Side Effects to Expect

Temporary blurred vision: May occur briefly after instillation. Do not drive or operate machinery until your vision is clear after each dose.

Eye redness or discomfort: Mild irritation is possible, especially when first starting the medication.

Watery eyes: Some patients experience increased tearing after instillation.

Serious Side Effects: What the Prescribing Information Warns About

Because Eysuvis is a corticosteroid, it carries the class-related risks of all topical ophthalmic steroids. These are rare during the approved 2-week course but important to know:

1. Elevated Intraocular Pressure (IOP)

Prolonged use of ophthalmic corticosteroids can increase pressure inside the eye (IOP), which — if persistent — can damage the optic nerve and lead to glaucoma. This risk is mitigated by Eysuvis's short (2-week) treatment duration and its unique metabolic profile — loteprednol etabonate is metabolized into inactive compounds, which may reduce the IOP elevation risk compared to other steroids. Your doctor should check your IOP before prescribing Eysuvis and at renewal. If you experience eye pain or significant vision changes, contact your doctor immediately.

2. Posterior Subcapsular Cataract Formation

Long-term use of ophthalmic corticosteroids can cause clouding of the lens (posterior subcapsular cataracts). This is primarily a risk with extended, repeated use — not typically a concern with a single 2-week course. However, patients who repeatedly use Eysuvis for frequent flares should discuss this risk with their eye doctor.

3. Delayed Wound Healing and Corneal Thinning

Topical corticosteroids can delay healing of the eye's surface. In patients with thin corneal or scleral tissue, this can rarely cause perforation. If you have a corneal abrasion, recent eye surgery, or very thin corneas, inform your doctor before using Eysuvis.

4. Secondary Eye Infections

Corticosteroids suppress the immune response, which can mask or worsen eye infections. Eysuvis is contraindicated in most viral eye infections including herpes simplex keratitis, vaccinia, and varicella. It should also not be used if you have a fungal or mycobacterial eye infection. If new redness, pain, or discharge develops during treatment, stop the medication and call your doctor.

Contact Lens Users: Important Note

The preservative in Eysuvis (benzalkonium chloride 0.01%) can be absorbed by soft contact lenses. Always remove your contacts before instilling Eysuvis, and wait at least 15 minutes before reinserting them. Do not skip this step — repeated exposure to BAK-absorbed lenses can irritate the eye surface over time.

When to Call Your Doctor Immediately

Contact your ophthalmologist or optometrist right away if you experience:

Sudden or significant pain in the eye that doesn't improve within 1-2 minutes of instillation

Worsening redness, itching, or inflammation while using Eysuvis — this may indicate an infection that's being masked by the steroid

New or worsening visual disturbances or significant loss of vision

Discharge from the eye (could suggest bacterial or viral infection)

Any signs of an allergic reaction such as swelling around the eyes, severe itching, or difficulty breathing

Pregnancy and Breastfeeding

There are no adequate and well-controlled studies of Eysuvis in pregnant women. Animal studies showed teratogenicity at high oral doses. Eysuvis should only be used during pregnancy if the potential benefit outweighs the risk. It's not known whether Eysuvis passes into breast milk. Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using Eysuvis.

The Bottom Line on Eysuvis Safety

Eysuvis has a favorable tolerability profile for a 2-week treatment course, with the most common side effect being mild instillation site pain in 5% of patients. The serious side effects associated with ophthalmic steroids are primarily concerns with long-term use, which is not how Eysuvis is intended to be used. For information on drug interactions, see our guide to Eysuvis drug interactions.