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The biologic responses to the administration of exogenous glucocorticoids (GCs) appear to be specific to cell type. As a result, progress in understanding how to improve the benefit-to-risk ratio of GC therapies for the eye will depend on better characterization of both the receptors and the proteins induced when these receptors are stimulated. The complexity and diversity of the GC receptors in human tissue is underscored by evidence that up to 6,000 genes are expressed or suppressed within hours of GC exposure. The enormous potential to use exogenous GC agents to downregulate processes involved in age-related macular degeneration must be balanced against a similar potential for counterproductive effects. Recent progress predicts an increasing precision with which GC steroids can be used to influence biologic functions.

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