Maxitrol eye drops are a prescription combination medication used to treat eye inflammation when a bacterial infection is present or likely to develop. The drops contain three active ingredients: two antibiotics (neomycin and polymyxin B) that kill bacteria, and a steroid (dexamethasone) that reduces redness, swelling, and irritation. This combination lets your doctor treat infection and inflammation at the same time with a single drop.
Conditions Maxitrol Treats
Maxitrol is specifically approved for inflammatory eye conditions where bacteria are involved or where the risk of bacterial infection is high. That covers a broad range of situations. The most common include bacterial conjunctivitis with significant inflammation, inflammation of the cornea, and swelling in the front chamber of the eye (a condition called anterior uveitis).
It’s also used after certain types of eye injuries. If your eye has been damaged by chemicals, radiation, heat, or a foreign object like a metal fragment or piece of debris, Maxitrol can help control the inflammation that follows while preventing bacteria from taking hold in the injured tissue. Post-surgical use is another common scenario, since the eye is vulnerable to both swelling and infection after a procedure.
The key distinction is that Maxitrol isn’t meant for inflammation alone or infection alone. It’s chosen when both problems overlap. If you only have a straightforward bacterial infection without much inflammation, a plain antibiotic drop would be more appropriate. If you only have inflammation without any bacterial concern, a steroid-only drop would be the better fit. Maxitrol fills the gap where you need both.
How the Three Ingredients Work
Each ingredient in Maxitrol handles a different part of the problem. Dexamethasone, the steroid component at 0.1% concentration, suppresses your eye’s inflammatory response. It dials down the redness, swelling, and discomfort that come with inflammation. The tradeoff is that steroids can also slow healing and make you more vulnerable to infection, which is exactly why the two antibiotics are included.
Neomycin and polymyxin B cover a wide range of bacteria commonly found in eye infections, including staph, E. coli, Pseudomonas, and several others. They work through different mechanisms, so together they’re effective against both the bacteria that typically cause eye infections and many of the opportunistic bacteria that might move in while the steroid is suppressing your immune response.
How to Use Maxitrol Drops
Maxitrol is a suspension, meaning the medication particles settle to the bottom of the bottle. You need to shake it well before every use so the dose is evenly mixed. The standard dose is one to two drops in the affected eye. For mild conditions, that’s typically four to six times per day. For severe inflammation, your doctor may have you use the drops as often as every hour, then gradually taper the frequency as your eye improves.
When applying the drops, pull down your lower eyelid to create a small pocket and drop the medication into that space. Avoid touching the dropper tip to your eye, your fingers, or any surface, since contamination can introduce new bacteria into the bottle. Close your eye gently for a moment after applying to let the medication spread across the surface.
Side Effects
Most people tolerate Maxitrol well for short courses. Uncommon side effects, occurring in roughly 1 to 10 out of every 1,000 users, include eye irritation, itching, discomfort, surface inflammation, and a temporary increase in eye pressure.
Less predictable reactions that have been reported include blurred vision, light sensitivity, increased tearing, eye redness, eye pain, and swelling. In rare cases, thinning of the cornea or corneal ulcers can develop. If you notice worsening pain, significant vision changes, or increased sensitivity to light while using Maxitrol, contact your prescriber promptly.
Risks of Prolonged Use
The steroid component is the main source of concern with longer treatment courses. If you use Maxitrol for 10 days or more, your eye pressure should be checked regularly. Elevated eye pressure from steroid drops can, over time, damage the optic nerve and lead to glaucoma, with permanent effects on your visual field and sharpness. Prolonged steroid use can also cause cataracts to form in the back of the lens.
Children face a higher risk of steroid-related pressure increases than adults, and the effect can show up sooner. People with diabetes are also at greater risk for both pressure elevation and cataract formation. Extended use also gradually suppresses your eye’s natural immune defenses, which raises the chance of developing a secondary infection, sometimes with organisms the antibiotics in Maxitrol don’t cover.
When Maxitrol Should Not Be Used
Maxitrol is contraindicated in most viral eye infections. Herpes simplex keratitis (the type that causes a branching pattern on the cornea), chickenpox-related eye disease, and vaccinia are all conditions where using a steroid drop can make things dramatically worse. The steroid suppresses the immune response your eye needs to fight the virus, allowing it to spread deeper into the tissue.
Fungal eye infections and mycobacterial infections (related to tuberculosis) are also strict contraindications. Because the steroid in Maxitrol masks symptoms like redness and pain, these infections can progress silently if the wrong diagnosis is made. This is one reason Maxitrol is prescription-only: your doctor needs to determine whether the inflammation in your eye is the type that benefits from a steroid or the type that would be made worse by one.
Storage
Store Maxitrol between 36°F and 77°F (2°C to 25°C). Keep the cap tightly closed when not in use, and don’t use the drops past their expiration date or if the suspension looks discolored or contains particles that won’t disperse after shaking.