Which of the following is NOT one of the main ocular side effects associated with topical corticosteroid use?

The development of cystoid macular edema (CME) is not considered one of the primary ocular side effects associated with the use of topical corticosteroids. The well-documented side effects of topical corticosteroids include increased intraocular pressure leading to glaucoma, the formation of posterior subcapsular cataracts (PSC), and an increased risk of secondary infections, including those caused by the Herpes simplex virus.

Corticosteroids are known to disrupt the normal wound healing process and can exacerbate existing infections, which is why the risk of secondary infections is a significant concern with their use. Additionally, the development of glaucoma is linked to the impact corticosteroids have on aqueous humor dynamics, increasing intraocular pressure. Finally, PSC cataracts result from the effects of corticosteroids on lens metabolism and existing lens integrity.

In contrast, while CME may occur in various conditions, it is not a direct side effect of topical corticosteroid treatment; rather, it is more commonly associated with other diseases or treatments, such as post-operative inflammation or certain retinal conditions. Hence, CME does not belong to the primary ocular side effects listed for topical corticosteroid use.