In keeping with their vital role in physiological homeostatic regulation, it’s not surprising that the benefits of pharmacologic application of glucocorticoids come with several significant side effects. For example, steroid use, especially prolonged use, is associated with immunosuppression, bacterial super-infection, delayed wound healing and osteoporosis.1,2 These side effects are dependent on both dosage and duration of therapy, and there’s little doubt that they’re manifestations of the physiological actions of the hormone. Beyond these adverse actions, ophthalmologists have specific concerns when considering use of steroid therapy: While these powerful drugs have great utility for a number of ocular conditions, they’re also linked to effects such as ptosis, stromal haze, increases in intraocular pressure and development of posterior subcapsular cataract.3,4 The solution to this problem is to develop a selective or partial glucocorticoid receptor agonist that preserves the anti-inflammatory action of the native steroid while minimizing the undesirable effects. This approach has worked with drugs acting at the related estrogen receptor such as tamoxifen or raloxifene.