Topical Insulin Eye Drops - Case Study & Preparation

Topical insulin eye drops can be a boon for patients unwilling to undergo tarsorrhaphy. Its a non invasive and affordable method for management of Neurotrophic keratopathy/ persistent epithelial defects. I recently managed a patient with grade 2 neurotrophic keratopathy over a two month period. He had been treated elsewhere with cocktail medications. The patient developed a hypopyon as well- which is rare but possible in Neurotrophic keratopathy.

I managed the case using a combination of preservative free lubricants, topical insulin and topical steroids. Topical steroids are Rarely used in Neurotrophic keratopathy and must be handled with extreme caution. Please don't prescribe them without a specialist opinion.

I found the case novel with great learning points. Sharing my approach with you. Hope you find it useful!