Tobradex Side Effects: What's Normal and What's Not

Tobradex (Tobramycin/Dexamethasone) is a prescription eye drop that combines an antibiotic with a steroid to treat bacterial eye infections and inflammation. Like all medications, it can cause side effects — some mild and temporary, others that need immediate medical attention.

This guide breaks down what to expect, what's serious, and when you should contact your doctor.

What Is Tobradex?

Tobradex is a combination ophthalmic medication containing Tobramycin (an aminoglycoside antibiotic) and Dexamethasone (a corticosteroid). It's prescribed for bacterial eye infections that also involve inflammation — conditions like bacterial conjunctivitis, blepharitis, and post-surgical eye infections. For a deeper look, see our full guide on what Tobradex is and how it's used.

Common Side Effects

Most people tolerate Tobradex well, but some experience mild side effects, especially during the first few days of treatment. These are generally harmless and often improve as your eyes adjust.

Common side effects from FDA labeling include:

• Eye redness — Mild redness in or around the treated eye
• Eye discomfort or irritation — A general feeling of irritation after applying the drops
• Burning or stinging — A brief burning sensation immediately after instilling the drops; this usually fades within a minute or two
• Itching — Mild itching in the eye or around the eyelids
• Eyelid itching or swelling — Slight puffiness or itching of the eyelids
• Blurred vision — Temporary blurring right after application, especially with the suspension form (it's a milky liquid)
• Sensitivity to light — Increased light sensitivity, which may be partly due to the underlying condition
• Tearing — Watery eyes after applying the drops

These side effects typically don't require medical attention unless they're severe or don't go away.

Serious Side Effects

While rare, Tobradex can cause serious side effects that require prompt medical care. These are more likely with prolonged use (typically beyond 10–14 days) or in people with certain risk factors.

Increased Eye Pressure (Glaucoma Risk)

The Dexamethasone component in Tobradex is a potent corticosteroid. Prolonged use can raise intraocular pressure (IOP), potentially leading to glaucoma. This is the most important risk to understand. Your doctor should monitor your eye pressure if treatment extends beyond a week or two.

Signs to watch for: Eye pain, headaches, halos around lights, gradual loss of peripheral vision.

Cataract Formation

Extended use of steroid eye drops, including Tobradex, can lead to posterior subcapsular cataracts. This is another reason treatment courses are typically kept short.

Secondary Infections

Steroids suppress the immune response in the eye. This means prolonged use can make you more susceptible to secondary fungal or viral eye infections. If your symptoms worsen or change character during treatment, contact your doctor immediately.

Delayed Wound Healing

The steroid component can slow the healing of corneal wounds. In patients with conditions that cause corneal thinning, there's a rare risk of corneal perforation.

Severe Allergic Reactions

In rare cases, Tobradex can cause serious allergic reactions including anaphylaxis, Stevens-Johnson syndrome, or erythema multiforme. Seek emergency medical care if you experience:

• Severe swelling of the face, lips, or throat
• Difficulty breathing
• Widespread skin rash or blistering
• Sudden severe eye pain or vision loss

Specific Populations

Some groups need extra caution with Tobradex:

Pregnant and Breastfeeding Women

Tobradex is Pregnancy Category C, meaning it should only be used during pregnancy if the potential benefit justifies the potential risk to the baby. If you're pregnant or breastfeeding, discuss the risks and benefits with your doctor.

Children

Tobradex is considered safe for children aged 2 months and older. However, children may be more sensitive to steroid effects, so treatment duration should be carefully monitored.

Older Adults

No specific dose adjustment is needed for elderly patients. However, older adults are at higher risk for glaucoma and cataracts, making pressure monitoring especially important during treatment.

Contact Lens Wearers

You should not wear contact lenses while using Tobradex. The preservatives in the drops can be absorbed by soft lenses, and wearing contacts during an eye infection can worsen the condition.

How to Manage Common Side Effects

Here are practical tips to reduce discomfort while using Tobradex:

• For burning or stinging — Close your eyes gently for 1–2 minutes after applying the drops. Some people find that refrigerating the drops (if permitted by the label) makes them more soothing.
• For blurred vision — Wait until your vision clears before driving or operating machinery. This usually takes a few minutes.
• For light sensitivity — Wear sunglasses outdoors during treatment.
• For eyelid irritation — Gently clean your eyelids with a warm, damp cloth.
• Space out your eye drops — If you're using multiple ophthalmic medications, wait at least 5 minutes between each one to avoid interactions and reduce irritation. Learn more about Tobradex drug interactions.

Most importantly, don't stop using Tobradex early just because of mild side effects. Stopping an antibiotic before the prescribed course is complete can allow the infection to return. If side effects are truly intolerable, call your doctor — they may switch you to an alternative medication.

When to Call Your Doctor

Contact your doctor or seek emergency care if you experience any of the following while using Tobradex:

• Sudden vision changes or vision loss
• Severe eye pain
• Worsening redness, swelling, or discharge after initial improvement
• New symptoms like white patches on the eye (possible fungal infection)
• Signs of allergic reaction (swelling, rash, difficulty breathing)
• Halos around lights or a persistent headache

Final Thoughts

Most Tobradex side effects are mild and temporary — some stinging, a little blurriness, maybe slightly watery eyes. These usually pass quickly. The serious risks — increased eye pressure, cataracts, secondary infections — are primarily associated with prolonged use, which is why doctors typically prescribe Tobradex for short courses of 5–14 days.

Follow your doctor's instructions, attend follow-up appointments, and don't hesitate to call if something doesn't feel right. Ready to fill your Tobradex prescription? Use Medfinder to find it in stock at a pharmacy near you.