Prakash Chand Agarwal

Abstract

Aim: To study the effect of 0.03% tacrolimus eye ointment in allergic eye disease Materials and Methods: This prospective study was conducted on patients suffering from recurrent allergic eye disease. All those patients who used steroids frequently because of recurrence or chronic refractory cases were included in this study. We included 48 cases in this study. Tacrolimus 0.03% eye ointment was used twice daily for 3 months and effect was seen in terms of improvement in symptoms, signs and any recurrence if occurred after stopping treatment. Results: Mean age of the patient was 21.04 7.02 and mean duration of allergic eye disease was 3.52 0.94. Symptoms and sign scores shown improvement after using tacrolimus eye ointment for 3 months. Itching and redness (88% & 82% respectively) improved dramatically at the end of 1 month. Recurrence was noticed at 6th month follow up in 6 cases after stopping tacrolimus eye ointment so it was restarted. While in 42 cases (87.5%) we didn’t notice any recurrence after stopping tacrolimus eye ointment. Conclusion: Tacrolimus eye ointment (0.03%) is effective in controlling allergic eye disease and is very effective steroid sparing drug in chronic recurrent cases where frequent use of steroids is required. Keywords: Allergic eye disease, Vernal keratoconjunctivitis, Perennial allergic conjunctivitis, Immunomodulators & mast cell stabilizers.

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Abstract

We report a series of 8 children with severe vernal keratoconjunctivitis who presented to us over last two years. The mean age was 7.375 years. The mean vision was 0.375 OD and 0.3625 OS. All these children were using topical steroids of varying strengths for more than two year. 2 out of 8 children had secondary glaucoma. The mean intraocular pressure was 21.75 + 4.74 OD and 23.25 + 6.25 mm of Hg OS. The highest IOP recorded was 28 mm Hg. All patients with glaucoma had early optic disc changes. Topical steroids were stopped for all patients and they were started on topical tacrolimus eye ointment (0.03%) twice a day along with lubricants. Patients relative were counseled to avoid eye rubbing, ignore minimal redness of eyes and counseled against any form of steroids. All patients continued tacrolimus for 3 months. Tacrolimus ointment was stopped at 3 month and lubricants were continued. Follow up was done at 1st week, 3rd week, 6th week, 3rd month and monthly thereafter till 6 months. At 6 months follow up all except one patient was discontinued of antiglaucoma medication. Keywords: VKC, Tacrolimus.

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